Asian Spine J.  2019 Oct;13(5):772-778. 10.31616/asj.2018.0324.

Characteristics of Low Back Pain due to Superior Cluneal Nerve Entrapment Neuropathy

• Miki K
• Kim K
• Isu T
• Matsumoto
• Kokubo R
• Isobe M
• Inoue T

• KMID: 2462006
• DOI: http://doi.org/10.31616/asj.2018.0324

Abstract

STUDY DESIGN: Retrospective analysis. PURPOSE: The present study aimed to investigate the features of low back pain (LBP) due to superior cluneal nerve (SCN) entrapment neuropathy (SCN-EN) using the Roland Morris Disability Questionnaire (RMDQ), and to analyze the differences between LBP due to SCN-EN and lumbar spinal canal stenosis (LSS). OVERVIEW OF LITERATURE: The SCN is derived from the cutaneous branches of the dorsal rami of T11-L5 and passes through the thoracolumbar fascia. LBP due to SCN-EN is exacerbated by various types of lumbar movement, and its features remain to be fully elucidated, often resulting in the misdiagnosis of lumbar spine disorder.
METHODS
The present study included 35 consecutive patients with SCN-EN treated via nerve blocks or surgical release between April 2016 and August 2017 (SCN-EN group; 16 men, 19 women; mean age, 65.5±17.0 years; age range, 19-89 years). During the same period, 33 patients were surgically treated with LSS (LSS group; 19 men, 14 women; mean age, 65.3±12.0 years; age range, 35-84 years). The characteristics of LBP were then compared between patients with SCN-EN and those with LSS using the RMDQ.
RESULTS
The duration of disease was significantly longer in the SCN-EN group than in the LSS group (26.0 vs. 16.0 months, p=0.012). Median RMDQ scores were significantly higher in the SCN-EN group (13 points; interquartile range, 8-15 points) than in the LSS group (7 points; interquartile range, 4-9 points; p<0.001). For seven items (question number 1, 8, 11, and 20-23), the ratio of positive responses was higher in the SCN-EN group than in the LSS group.
CONCLUSIONS
Patients with SCN-EN exhibit significantly higher RMDQ scores and greater levels of disability due to LBP than patients with LSS. The findings further demonstrate that SCN-EN may affect physical and psychological function.

Keyword

Peripheral nerve; Nerve compression syndrome; Low back pain; Spine

MeSH Terms

Constriction, Pathologic
Diagnostic Errors
Fascia
Female
Humans
Low Back Pain*
Male
Nerve Block
Nerve Compression Syndromes*
Peripheral Nerves
Retrospective Studies
Spinal Canal
Spine