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Surg Neurol Int. 2015 Nov 25;6(Suppl 24):S619-21. doi: 10.4103/2152-7806.170455. eCollection 2015.

Treatment of low back pain in patients with vertebral compression fractures and superior cluneal nerve entrapment neuropathies.

Author information

1
Department of Neurosurgery, Chiba Hokuso Hospital, Nippon Medical School, Inzai, Chiba, Japan.
2
Department of Neurosurgery, Kushiro Rosai Hospital, Kushiro, Hokkaido, Japan.
3
Department of Neurosurgery, Nippon Medical School, Tokyo, Japan.
4
Department of Neurology, Sapporo Yamanoue Hospital, Spporo, Hokkaido, Japan.

Abstract

BACKGROUND:

Superior cluneal nerve entrapment neuropathy (SCN-EN) may contribute to low back pain (LBP). However, it is often misdiagnosed as lumbar spine disorder and poorly understood.

METHODS:

Between April 2012 and September 2013, we treated 27 patients (3 men, 24 women; mean age 75.0 years) with LBP due to SCN-EN elicited by vertebral compression fractures. Symptoms were unilateral in 4 patients and bilateral in 23 patients. The interval between symptom onset and treatment averaged 10.8 months; the mean postoperative follow-up period was 19.0 months. The clinical outcomes were assessed utilizing the numeric rating scale (NRS) for LBP, the Japanese Orthopedic Association (JOA) score, and the Roland-Morris Disability Questionnaire (RDQ) before and after treatment (e.g., until the latest follow-up).

RESULTS:

LBP in 17 patients was immediately improved by SCN block only. The remaining 10 patients required surgery (involving 18 sites) as SCN blocks were only transiently effective. Operative intervention resulted in the immediate and continued improvement of their LBP. Notably, their NRS decreased from 7.4 to 1.5, their RDQ scores from 19.6 to 7.0, and their JOA scores increased from 10.7 to 20.3.

CONCLUSIONS:

In this series, 27 patients with LBP due to SCN-EN responded either to SCN blocks (17 patients) or surgical release of SCN entrapment (10 patients at 18 sites).

KEYWORDS:

Entrapment neuropathy; less invasive; low back pain; neurolysis; superior cluneal nerve; vertebral compression fracture

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