The frequency of superior cluneal nerve entrapment diagnosed with ultrasound-guided nerve block in patients with low back pain: A prospective, cross-sectional study.

IF 2.5 3区 医学 Q2 ANESTHESIOLOGY Pain Practice Pub Date : 2024-11-01 Epub Date: 2024-06-07 DOI:10.1111/papr.13391
Busra Sezer Kiral, Tugce Ozekli Misirlioglu, Rana Terlemez, Deniz Palamar, Dogan Kiral, Eren Aygun, Kenan Akgun
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Abstract

Introduction: To determine the frequency of superior cluneal nerve entrapment (SCN-E) in patients who applied to our outpatient clinic with low back pain.

Methods: Two hundred patients with mechanical low back pain persisting more than 3 months were included in our study. All patients were evaluated with detailed clinical history and physical examination. Ultrasound-guided diagnostic injection was performed in patients who had tenderness on the posterior iliac crest and whose main complaint emerged by pressing on this point. Patients with 70% or greater pain relief 1 h after the injection were considered as SCN-E. The frequency and clinical features of SCN-E were determined and compared with other mechanical low back pain.

Results: The mean age of the patients included in our study was 48.56 ± 14.11 years, with 138 female and 62 male patients. The diagnostic injection was performed on 31 patients and considered positive in 24 of them. The frequency of SCN-E was determined as 12%. The Hip-Knee Flexion Test was determined to be more specific for SCN-E than other causes of low back pain, the sensitivity and specificity of the test were 41.67% and 88.64% (p = 0.001; p < 0.01). In addition, all demographic and clinical features in patients diagnosed with SCN-E were found to be similar to other mechanical low back pain cases.

Conclusions: In patients with chronic low back pain, SCN-E is not a rare cause and is often overlooked. Increasing the awareness and experience of physicians on SCN-E will prevent patients from being exposed to unnecessary surgical or non-surgical treatments.

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通过超声引导神经阻滞诊断腰背痛患者上锁骨神经卡压的频率:一项前瞻性横断面研究。
简介:目的目的:确定因腰痛到我院门诊就诊的患者中发生上锁骨神经卡压(SCN-E)的频率:研究纳入了 200 名持续 3 个月以上的机械性腰背痛患者。所有患者均接受了详细的临床病史和体格检查。对髂后嵴有压痛且按压该穴位出现主诉的患者进行超声引导诊断性注射。注射后 1 小时疼痛缓解 70% 或以上的患者被视为 SCN-E。确定了 SCN-E 的频率和临床特征,并与其他机械性腰痛进行了比较:研究对象的平均年龄为(48.56 ± 14.11)岁,其中女性 138 人,男性 62 人。对 31 例患者进行了诊断性注射,其中 24 例为阳性。SCN-E的发生率为12%。髋膝屈曲试验对 SCN-E 的特异性高于其他原因引起的腰背痛,其敏感性和特异性分别为 41.67% 和 88.64%(P = 0.001;P 结论:髋膝屈曲试验对 SCN-E 的特异性高于其他原因引起的腰背痛,其敏感性和特异性分别为 41.67% 和 88.64%(P = 0.001):在慢性腰背痛患者中,SCN-E 并非罕见病因,却常常被忽视。提高医生对 SCN-E 的认识和经验将避免患者接受不必要的手术或非手术治疗。
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来源期刊
Pain Practice
Pain Practice ANESTHESIOLOGY-CLINICAL NEUROLOGY
CiteScore
5.60
自引率
3.80%
发文量
92
审稿时长
6-12 weeks
期刊介绍: Pain Practice, the official journal of the World Institute of Pain, publishes international multidisciplinary articles on pain and analgesia that provide its readership with up-to-date research, evaluation methods, and techniques for pain management. Special sections including the Consultant’s Corner, Images in Pain Practice, Case Studies from Mayo, Tutorials, and the Evidence-Based Medicine combine to give pain researchers, pain clinicians and pain fellows in training a systematic approach to continuing education in pain medicine. Prior to publication, all articles and reviews undergo peer review by at least two experts in the field.
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