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Superior cluneal nerve entrapment

Last revised by Joachim Feger on 31 Dec 2022

Superior cluneal nerve entrapment is a potential cause of low back pain. The nerves travel underneath the thoracolumbar fascia and within the osteofibrous tunnel of the iliac crest and this is a potential space for nerve entrapment 1,2.

Low back pain and radiating leg pain are common symptoms of this condition. Pain is exacerbated with extension or retroversion of the lumbar spine with bending, rotating and prolonged walking. Tinel test is positive at the site of nerve penetration into thoracolumbar fascia 3.

The superior cluneal nerves are very thin and CT and MRI are not diagnostic for this condition. High-resolution CT might be useful in detecting any bony abnormalities within an osteofibrous tunnel.

A nerve block can help to alleviate pain and also aid in diagnosis. Surgical decompression is considered for refractory cases 3,4.

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