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Low back pain due to superior cluneal nerve entrapment: A clinicopathologic study
Author(s) -
Kim Kyongsong,
Shimizu Jun,
Isu Toyohiko,
Inoue Kiyoharu,
Chiba Yasuhiro,
Iwamoto Naotaka,
Morimoto Daijiro,
Isobe Masanori,
Morita Akio
Publication year - 2018
Publication title -
muscle and nerve
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.025
H-Index - 145
eISSN - 1097-4598
pISSN - 0148-639X
DOI - 10.1002/mus.26007
Subject(s) - entrapment , entrapment neuropathy , medicine , physical medicine and rehabilitation , anatomy , anesthesia , surgery , carpal tunnel syndrome
We studied the clinical and nerve pathologic features in 6 patients whose low back pain (LBP) was relieved by superior cluneal nerve (SCN) neurectomy to determine whether nerve compression was the mechanism underlying this type of LBP. Methods All 6 patients (7 nerves) underwent SCN neurectomy for intractable LBP. Their clinical outcomes and the pathologic features of 7 nerves were reviewed. Results All patients reported LBP relief immediately after SCN neurectomy. Pathologic study of the 7 resected nerves showed marked enlargement, decreased myelinated fiber density, an increase in thinly myelinated fibers ( n = 2), perineurial thickening ( n = 5), subperineurial edema ( n = 4), and Renaut bodies ( n = 4). At the distal end of 1 enlarged nerve, we observed a moderate reduction in the density and marked reduction in the number of large myelinated fibers. Discussion The pathologic findings and effectiveness of neurectomy suggest that, in our patients, SCN neuropathy likely elicited LBP via nerve compression. Muscle Nerve 57 : 777–783, 2018