The frequency of superior cluneal nerve entrapment diagnosed with ultrasound-guided nerve block in patients with low back pain: A prospective, cross-sectional study


Kiral B. S., Misirlioglu T., Terlemez R., Palamar D., Kiral D., Aygun E., ...Daha Fazla

PAIN PRACTICE, cilt.24, sa.8, ss.989-996, 2024 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 24 Sayı: 8
  • Basım Tarihi: 2024
  • Doi Numarası: 10.1111/papr.13391
  • Dergi Adı: PAIN PRACTICE
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED)
  • Sayfa Sayıları: ss.989-996
  • Anahtar Kelimeler: cluneal nerve, low back pain, peripheral nerve block, superior cluneal nerve entrapment, ultrasonography
  • İstanbul Üniversitesi-Cerrahpaşa Adresli: Evet

Özet

Introduction: To determine the frequency of superior cluneal nerve entrapment (SCN-E) in patients who applied to our outpatient clinic with low back pain. Methods: Two hundred patients with mechanical low back pain persisting more than 3 months were included in our study. All patients were evaluated with detailed clinical history and physical examination. Ultrasound-guided diagnostic injection was performed in patients who had tenderness on the posterior iliac crest and whose main complaint emerged by pressing on this point. Patients with 70% or greater pain relief 1 h after the injection were considered as SCN-E. The frequency and clinical features of SCN-E were determined and compared with other mechanical low back pain. Results: The mean age of the patients included in our study was 48.56 +/- 14.11 years, with 138 female and 62 male patients. The diagnostic injection was performed on 31 patients and considered positive in 24 of them. The frequency of SCN-E was determined as 12%. The Hip-Knee Flexion Test was determined to be more specific for SCN-E than other causes of low back pain, the sensitivity and specificity of the test were 41.67% and 88.64% (p = 0.001; p < 0.01). In addition, all demographic and clinical features in patients diagnosed with SCN-E were found to be similar to other mechanical low back pain cases. Conclusions: In patients with chronic low back pain, SCN-E is not a rare cause and is often overlooked. Increasing the awareness and experience of physicians on SCN-E will prevent patients from being exposed to unnecessary surgical or non-surgical treatments.