Talu G K, Ozyalçin S, Talu U
Department of Algology, Medical Faculty of Istanbul, Istanbul University, Monoblok, Capa Klinikleri, 34390 Capa, Istanbul, Turkey.
Reg Anesth Pain Med. 2000 Nov-Dec;25(6):648-50. doi: 10.1053/rapm.2000.18189.
Pain due to superior cluneal nerve entrapment is an infrequent cause of unilateral low back pain. Here we present a case of acute unilateral low back pain treated by superior cluneal nerve (SCN) block.
A 55-year-old woman presented to the outpatient clinic suffering from unilateral low back pain localized to right iliac crest and radiating to the right buttock. Her history was taken, physical examination was performed, and a thorough radiologic evaluation was performed to minimize radiculopathy and facet syndromes as causative. After transient pain relief with a diagnostic trigger point injection, entrapment of SCN was diagnosed and therapeutic nerve block with local anesthetic and steroid combination was performed.
SCN is prone to entrapment where it passes through the fascia near the posterior iliac crest. Unilateral low back pain and deep tenderness radiating to the ipsilateral buttock are the clinical findings accompanying SCN entrapment. The case presented emphasizes the relief of possible SCN after limiting other etiologic causes of low back pain.
臀上皮神经卡压所致疼痛是单侧下腰痛的少见原因。在此,我们报告一例经臀上皮神经(SCN)阻滞治疗的急性单侧下腰痛病例。
一名55岁女性因单侧下腰痛就诊于门诊,疼痛局限于右髂嵴并放射至右臀部。采集了她的病史,进行了体格检查,并进行了全面的影像学评估,以排除神经根病和小关节综合征等病因。在诊断性触发点注射后短暂缓解疼痛后,诊断为SCN卡压,并进行了局部麻醉药和类固醇联合治疗性神经阻滞。
SCN在穿过髂嵴后方附近的筋膜时容易发生卡压。单侧下腰痛和向同侧臀部放射的深部压痛是SCN卡压的临床表现。本病例强调在排除其他下腰痛病因后,可能缓解SCN卡压所致疼痛。