Low back pain due to superior cluneal nerve entrapment: A clinicopathologic study.

Abstract

INTRODUCTION:

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.

• Authors: Kyongsong Kim, Jun Shimizu, Toyohiko Isu, Kiyoharu Inoue, Yasuhiro Chiba, Naotaka Iwamoto, Daijiro Morimoto, Masanori Isobe, Akio Morita
• Journal: Muscle & nerve (Muscle Nerve) Vol. 57 Issue 5 Pg. 777-783 (05 2018) ISSN: 1097-4598 [Electronic] United States
• PMID: 29105105 (Publication Type: Journal Article)
• Copyright: © 2017 Wiley Periodicals, Inc.

Topics

• Adult
• Aged
• Female
• Femoral Nerve (pathology, surgery, ultrastructure)
• Follow-Up Studies
• Humans
• Low Back Pain (etiology, pathology)
• Lumbosacral Plexus (pathology, ultrastructure)
• Male
• Middle Aged
• Nerve Compression Syndromes (etiology, surgery)
• Neurosurgical Procedures (methods)
• Surveys and Questionnaires