Editorial
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Mar 18, 2016; 7(3): 167-170
Published online Mar 18, 2016. doi: 10.5312/wjo.v7.i3.167
Entrapment of middle cluneal nerves as an unknown cause of low back pain
Yoichi Aota
Yoichi Aota, Department of Spine and Spinal Cord Surgery, Yokohama Brain and Spine Center, Yokohama 235-0012, Kanagawa Prefecture, Japan
Author contributions: Aota Y conceived the issues which formed the content of the manuscript and wrote the manuscript.
Conflict-of-interest statement: The author has no conflict of interests.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Yoichi Aota, MD, Department of Spine and Spinal Cord Surgery, Yokohama Brain and Spine Center, Takigashira 1-2-1, Isogo-ku, Yokohama 235-0012, Kanagawa Prefecture, Japan. yaota@yokohama-cu.ac.jp
Telephone: +81-45-7532500 Fax: +81-45-7532859
Received: September 6, 2015
Peer-review started: September 8, 2015
First decision: October 16, 2015
Revised: October 17, 2015
Accepted: December 18, 2015
Article in press: December 21, 2015
Published online: March 18, 2016
Processing time: 184 Days and 23.2 Hours
Abstract

Entrapment of middle cluneal nerves induces low back pain and leg symptoms. The middle cluneal nerves can become spontaneously entrapped where this nerve pass under the long posterior sacroiliac ligament. A case of severe low back pain, which was completely treated by release of the middle cluneal nerve, was presented. Entrapment of middle cluneal nerves is possibly underdiagnosed cause of low-back and/or leg symptoms. Spinal surgeons should be aware of this clinical entity and avoid unnecessary spinal surgeries and sacroiliac fusion. This paper is to draw attention by pain clinicians in this unrecognized etiology.

Keywords: Entrapment neuropathy; Superior cluneal nerve; Middle cluneal nerve; Sacroiliac joint; Low back pain; Neuropathic pain

Core tip: A case of severe low back pain, which was completely treated by release of the middle cluneal nerve, was presented. Clunealgia is underdiagnosed cause of low back pain and leg pain. The middle cluneal nerve may be entrapped where this nerve pass under or through the long posterior sacroiliac ligament.