title: Surgical treatment of superior cluneal nerve entrapment neuropathy.
abstract: OBJECTIVE
  Superior cluneal nerve (SCN) entrapment neuropathy is a poorly understood clinical entity that can produce low-back pain. The authors report a less-invasive surgical treatment for SCN entrapment neuropathy that can be performed with local anesthesia.
  
  
  METHODS
  From November 2010 through November 2011, the authors performed surgery in 34 patients (age range 18-83 years; mean 64 years) with SCN entrapment neuropathy. The entrapment was unilateral in 13 patients and bilateral in 21. The mean postoperative follow-up period was 10 months (range 6-18 months). After the site was blocked with local anesthesia, the thoracolumbar fascia of the orifice was dissected with microscissors in a distal-to-rostral direction along the SCN to release the entrapped nerve.
  
  
  RESULTS
  were evaluated according to Japanese Orthopaedic Association (JOA) and Roland-Morris Disability Questionnaire (RMDQ) scores. Results In all 34 patients, the SCN penetrated the orifice of the thoracolumbar fascia and could be released by dissection of the fascia. There were no intraoperative surgery-related complications. For all patients, surgery was effective; JOA and RMDQ scores indicated significant improvement (p < 0.05).
  
  
  CONCLUSIONS
  For patients with low-back pain, SCN entrapment neuropathy must be considered as a causative factor. Treatment by less-invasive surgery, with local anesthesia, yielded excellent clinical outcomes.
authors.affiliation: Department of Neurosurgery, Kushiro Rosai Hospital, Hokkaido, Japan. dai_sampo@yahoo.co.jp
authors.forename: Daijiro
authors.initials: D
authors.lastname: Morimoto
authors.forename: Toyohiko
authors.initials: T
authors.lastname: Isu
authors.forename: Kyongsong
authors.initials: K
authors.lastname: Kim
authors.forename: Tetsuaki
authors.initials: T
authors.lastname: Imai
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Yamazaki
authors.forename: Ryoji
authors.initials: R
authors.lastname: Matsumoto
authors.forename: Masanori
authors.initials: M
authors.lastname: Isobe
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017116:Low Back Pain / Q000209:etiology / Q000601:surgery; D008160:Lumbosacral Plexus / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009408:Nerve Compression Syndromes / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000379:methods*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult