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Treatment of low back pain elicited by superior cluneal nerve entrapment neuropathy after lumbar fusion surgery.
Spine Surg Relat Res 2017; 1(3):152-157SS

Abstract

Object

Low back pain (LBP) attributable to fusion failure, implant failure, infection, malalignment, or adjacent segment disease may persist after lumbar fusion surgery (LFS). Superior cluneal nerve (SCN) entrapment neuropathy (SCNEN) is a clinical entity that can produce LBP. We report that SCNEN treatment improved LBP in patients who had undergone LFS.

Methods

Between April 2012 and August 2015, we treated 8 patients (4 men and 4 women ranging in age from 38 to 88 years; mean age, 69 years) with SCNEN for their LBP after LFS. Our criteria for the diagnosis of SCNEN included a trigger point over the posterior iliac crest 7 cm from the midline and numbness and radiating pain in the SCN area upon compression of the trigger point. Symptom relief was obtained in more than 75% of patients within 2 h of inducing a local nerve block at the trigger point in the buttocks. The mean postoperative follow-up period was 28 months (range, 9-54 months).

Results

LBP was unilateral in 3 and bilateral in 5 patients. The senior author (T.I.) operated all patients for SCNEN under local anesthesia because they reported recurrence of pain after the analgesic effect of repeat injections wore off. This led to a significant improvement of their LBP.

Conclusions

SCNEN should be considered in patients reporting LBP after LFS. Treatment of SCNEN may be a useful option in patients with failed back surgery syndrome after LFS.

Authors+Show Affiliations

Department of Neurosurgery, Kushiro Rosai Hospital, Hokkaido, Japan. Department of Neurosurgery, Teikyo University Hospital, Tokyo, Japan.Department of Neurosurgery, Kushiro Rosai Hospital, Hokkaido, Japan.Department of Neurosurgery, Chiba Hokuso Hospital, Nippon Medical School, Chiba, Japan.Department of Neurosurgery, Kushiro Rosai Hospital, Hokkaido, Japan.Department of Neurosurgery, Nippon Medical School Hospital, Tokyo, Japan.Department of Neurosurgery, Kushiro Rosai Hospital, Hokkaido, Japan.Department of Neurosurgery, Kushiro Rosai Hospital, Hokkaido, Japan.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31440627

Citation

Iwamoto, Naotaka, et al. "Treatment of Low Back Pain Elicited By Superior Cluneal Nerve Entrapment Neuropathy After Lumbar Fusion Surgery." Spine Surgery and Related Research, vol. 1, no. 3, 2017, pp. 152-157.
Iwamoto N, Isu T, Kim K, et al. Treatment of low back pain elicited by superior cluneal nerve entrapment neuropathy after lumbar fusion surgery. Spine Surg Relat Res. 2017;1(3):152-157.
Iwamoto, N., Isu, T., Kim, K., Chiba, Y., Morimoto, D., Matsumoto, J., & Isobe, M. (2017). Treatment of low back pain elicited by superior cluneal nerve entrapment neuropathy after lumbar fusion surgery. Spine Surgery and Related Research, 1(3), pp. 152-157. doi:10.22603/ssrr.1.2016-0027.
Iwamoto N, et al. Treatment of Low Back Pain Elicited By Superior Cluneal Nerve Entrapment Neuropathy After Lumbar Fusion Surgery. Spine Surg Relat Res. 2017;1(3):152-157. PubMed PMID: 31440627.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Treatment of low back pain elicited by superior cluneal nerve entrapment neuropathy after lumbar fusion surgery. AU - Iwamoto,Naotaka, AU - Isu,Toyohiko, AU - Kim,Kyongsong, AU - Chiba,Yasuhiro, AU - Morimoto,Daijiro, AU - Matsumoto,Juntaro, AU - Isobe,Masanori, Y1 - 2017/12/20/ PY - 2016/12/12/received PY - 2017/03/15/accepted PY - 2019/8/24/entrez PY - 2017/12/20/pubmed PY - 2017/12/20/medline KW - Superior cluneal nerve entrapment neuropathy KW - low back pain KW - lumbar fusion surgery SP - 152 EP - 157 JF - Spine surgery and related research JO - Spine Surg Relat Res VL - 1 IS - 3 N2 - Object: Low back pain (LBP) attributable to fusion failure, implant failure, infection, malalignment, or adjacent segment disease may persist after lumbar fusion surgery (LFS). Superior cluneal nerve (SCN) entrapment neuropathy (SCNEN) is a clinical entity that can produce LBP. We report that SCNEN treatment improved LBP in patients who had undergone LFS. Methods: Between April 2012 and August 2015, we treated 8 patients (4 men and 4 women ranging in age from 38 to 88 years; mean age, 69 years) with SCNEN for their LBP after LFS. Our criteria for the diagnosis of SCNEN included a trigger point over the posterior iliac crest 7 cm from the midline and numbness and radiating pain in the SCN area upon compression of the trigger point. Symptom relief was obtained in more than 75% of patients within 2 h of inducing a local nerve block at the trigger point in the buttocks. The mean postoperative follow-up period was 28 months (range, 9-54 months). Results: LBP was unilateral in 3 and bilateral in 5 patients. The senior author (T.I.) operated all patients for SCNEN under local anesthesia because they reported recurrence of pain after the analgesic effect of repeat injections wore off. This led to a significant improvement of their LBP. Conclusions: SCNEN should be considered in patients reporting LBP after LFS. Treatment of SCNEN may be a useful option in patients with failed back surgery syndrome after LFS. SN - 2432-261X UR - https://www.unboundmedicine.com/medline/citation/31440627/Treatment_of_low_back_pain_elicited_by_superior_cluneal_nerve_entrapment_neuropathy_after_lumbar_fusion_surgery L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/31440627/ DB - PRIME DP - Unbound Medicine ER -