title: Alcohol neurolysis for persistent pain caused by superior cluneal nerves injury after iliac crest bone graft harvesting in orthopedic surgery: report of four cases and review of the literature.
abstract: METHODS
  Harvesting of autologous bone graft from the posterior iliac crest for lumbar spinal fusions is a frequently performed procedure in orthopedic surgery. The most common complication associated with this procedure is an alteration in sensation over the donor site manifested as chronic pain, hyperesthesia, dysesthesia, or diminished sensitivity resulting from superior cluneal nerve (SCN) injury.
  
  
  OBJECTIVE
  To predict the effectiveness of alcohol neurolysis in the treatment of persistent pain caused by the entrapment of superior cluneal nerves.
  
  
  BACKGROUND
  The subjects of this study were patients with intractable pain in donor area after conventional treatments using a transverse incision, which is parallel to posterior iliac crest. The study group was composed of four patients who underwent surgery in a 1-year period and experienced chronic pain resulting from superior cluneal nerve injury.
  
  
  METHODS
  No reports describing alcohol neurolysis of the superior cluneal nerve exist in the relevant literature. All four patients in this study were treated with alcohol neurolysis of the superior cluneal nerves.
  
  
  RESULTS
  The study patients were observed up to 4 years, and none of them reported any problems.
  
  
  CONCLUSIONS
  The authors suggest that conventional treatments be limited to a 2-month period, and that alcohol neurolysis be applied as soon as possible to prevent lengthy pain experiences.
authors.affiliation: Department of Anesthesiology and Reanimation, Gazi University Medical Faculty, Ankara, Turkey. mahli@med.gazi.edu.tr
authors.forename: Ahmet
authors.initials: A
authors.lastname: Mahli
authors.forename: Demet
authors.initials: D
authors.lastname: Coskun
authors.forename: Necdet Sukru
authors.initials: NS
authors.lastname: Altun
authors.forename: Aykln
authors.initials: A
authors.lastname: Simsek
authors.forename: Esra
authors.initials: E
authors.lastname: Ocal
authors.forename: Metin
authors.initials: M
authors.lastname: Kostekci
mesh_terms: D000328:Adult; D016025:Bone Transplantation / Q000009:adverse effects*; D002081:Buttocks / Q000294:innervation; D002908:Chronic Disease; D000431:Ethanol / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007085:Ilium / Q000294:innervation / Q000601:surgery / Q000637:transplantation; D008297:Male; D019637:Orthopedic Procedures / Q000009:adverse effects*; D010146:Pain / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D059348:Peripheral Nerve Injuries; D010525:Peripheral Nerves / Q000187:drug effects / Q000503:physiopathology; D010523:Peripheral Nervous System Diseases / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D016896:Treatment Outcome
chemical_list: D000431:Ethanol