Akbas Mert, Yegin Arif, Karsli Bilge
Department of Anesthesiology, Division of Algology, Akdeniz University Medical Faculty, Antalya, Turkey.
Pain Pract. 2005 Dec;5(4):364-6. doi: 10.1111/j.1533-2500.2005.00040.x.
Superior cluneal nerve (SCN) entrapment is one of the infrequent etiologies of low back pain (LBP), which is rarely diagnosed. Few clinical reports have been published in the literature. We present a case of severe LBP radiating to the ipsilateral buttock after decubitus surgery.
A 62-year-old man weighing 85 kg presented to the algology department, suffering from severe LBP of 6 months duration. The pain was in the right iliac crest region with radiation to the ipsilateral buttock. After admission, his history was taken, physical examination was performed, and further evaluations were made. He was suspected of having facet and right sacroiliac joint pain. Two tender points were found 6.5 and 7.5 cm to the right of the midline over the iliac crest. Local anesthetic with corticosteroid was injected at the tender points over the right iliac crest. Five minutes after the injection, the pain dissipated.
SCN entrapment should be considered in patients who suffer from LBP radiating to the iliac crest and buttock after other causes of LBP have been excluded.
臀上皮神经(SCN)卡压是下腰痛(LBP)的罕见病因之一,很少被诊断出来。文献中发表的临床报告很少。我们报告一例在褥疮手术后出现严重LBP并放射至同侧臀部的病例。
一名体重85公斤的62岁男性因持续6个月的严重LBP就诊于疼痛科。疼痛位于右髂嵴区域,并放射至同侧臀部。入院后,采集了他的病史,进行了体格检查,并做了进一步评估。怀疑他患有小关节和右骶髂关节疼痛。在髂嵴中线右侧6.5厘米和7.5厘米处发现两个压痛点。在右髂嵴的压痛点处注射了局部麻醉剂和皮质类固醇。注射后五分钟,疼痛消失。
在排除其他LBP病因后,对于出现放射至髂嵴和臀部的LBP患者,应考虑SCN卡压。