{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T15:20:51Z","timestamp":1788016851559,"version":"build-2784847793"},"reference-count":20,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["SPI"],"published-print":{"date-parts":[[2016,2]]},"abstract":"\nOBJECT<\/jats:title>\nSuperior cluneal nerve (SCN) entrapment neuropathy (SCNEN) is a cause of low-back pain (LBP) that can be misdiagnosed as a lumbar spine disorder. The clinical features and etiology of LBP remain poorly understood. In this study, 5 patients with intermittent LBP due to SCNEN who had previously received conservative treatment underwent surgery. The findings are reported and the etiology of LBP is discussed to determine whether it is attributable to SCNEN.<\/jats:p><\/jats:sec>\n\nMETHODS<\/jats:title>\nIntermittent LBP is defined as a clinical condition in which pain is induced by standing or walking but is absent at rest. Between April 2012 and March 2013, 5 patients in this study who had intermittent LBP due to SCNEN underwent surgery. The patients included 3 men and 2 women, with a mean age of 66 years. The affected side was unilateral in 2 patients and bilateral in 3 (total sites, 8). The interval from symptom onset to treatment averaged 51.4 months; the mean postoperative follow-up period was 17.6 months. The clinical outcomes were assessed using the numerical rating scale (NRS) for LBP, the Japanese Orthopaedic Association (JOA) scale, and the Roland-Morris Disability Questionnaire (RDQ) preoperatively and at the last follow-up; these data were analyzed statistically.<\/jats:p><\/jats:sec>\n\nRESULTS<\/jats:title>\nNone of the 5 patients reported LBP at rest. Intermittent LBP involving the iliac crest and buttocks was induced by standing or walking an average of 136 m. In 2 patients with unilateral involvement, LBP was improved only by SCN block. Surgeries were performed on 6 sites in 5 patients because the SCN block was only transiently effective. Patients\u2019 SCNs penetrated the orifice of the thoracolumbar fascia. SCN kinking at the orifice was exacerbated at the lumbar-extension provocation posture, and radiating pain increased upon manual intraoperative compression of the SCN in this posture. After releasing the SCN surgically, disappearance of the pain was intraoperatively confirmed by manual compression of the SCN with the patients in the lumbar-extension posture. Surgery was effective in all 5 patients, and all clinical outcome scores indicated significant improvement (p < 0.05).<\/jats:p><\/jats:sec>\n\nCONCLUSIONS<\/jats:title>\nTo the authors\u2019 knowledge, this is the first report of patients with intermittent LBP due to SCNEN. Clinical and surgical evidence presented suggests that their LBP was exacerbated by lumbar extension and that symptom relief was obtained by SCN block or surgical release of the SCN entrapment. These results suggest that SCNEN should be considered as a causal factor in patients for whom walking elicits LBP.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2015.1.spine14173","type":"journal-article","created":{"date-parts":[[2015,10,13]],"date-time":"2015-10-13T23:52:41Z","timestamp":1444780361000},"page":"263-267","source":"Crossref","is-referenced-by-count":27,"title":["Association between intermittent low-back pain and superior cluneal nerve entrapment neuropathy"],"prefix":"10.3171","volume":"24","author":[{"given":"Yasuhiro","family":"Chiba","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Kushiro Rosai Hospital, Hokkaido;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toyohiko","family":"Isu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Kushiro Rosai Hospital, Hokkaido;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyongsong","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Chiba Hokuso Hospital, Nippon Medical School, Chiba;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naotaka","family":"Iwamoto","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Kushiro Rosai Hospital, Hokkaido;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daijiro","family":"Morimoto","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Nippon Medical School, Tokyo; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuyoshi","family":"Yamazaki","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Kushiro Rosai Hospital, Hokkaido;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaaki","family":"Hokari","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Kushiro Rosai Hospital, Hokkaido;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masanori","family":"Isobe","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Kushiro Rosai Hospital, Hokkaido;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitsuo","family":"Kusano","sequence":"additional","affiliation":[{"name":"Department of Surgery, Kushiro Rosai Hospital, Hokkaido, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-spine14173","series-title":"Pain Pract","doi-asserted-by":"publisher","first-page":"364","DOI":"10.1111\/j.1533-2500.2005.00040.x","article-title":"Superior cluneal nerve entrapment eight years after decubitus surgery","volume":"5","author":"Akbas","year":"2005"},{"key":"b2-spine14173","series-title":"Tohoku J Exp Med","doi-asserted-by":"publisher","first-page":"229","DOI":"10.1620\/tjem.197.229","article-title":"Medial superior cluneal nerve entrapment neuropathy in teenagers: a report of two cases","volume":"197","author":"Aly","year":"2002"},{"key":"b3-spine14173","series-title":"J Rheumatol","first-page":"2179","article-title":"A potentially underrecognized and treatable cause of chronic back pain: entrapment neuropathy of the cluneal nerves","volume":"23","author":"Berthelot","year":"1996"},{"key":"b4-spine14173","series-title":"N Engl J Med","doi-asserted-by":"publisher","first-page":"363","DOI":"10.1056\/NEJM200102013440508","article-title":"Low back pain","volume":"344","author":"Deyo","year":"2001"},{"key":"b5-spine14173","series-title":"J Am Acad Orthop Surg","doi-asserted-by":"publisher","first-page":"239","DOI":"10.5435\/00124635-199907000-00004","article-title":"Degenerative lumbar stenosis: diagnosis and management","volume":"7","author":"Hilibrand","year":"1999"},{"key":"b6-spine14173","series-title":"Arthritis Rheum","doi-asserted-by":"publisher","first-page":"1236","DOI":"10.1002\/art.1780380910","article-title":"Degenerative lumbar spinal stenosis. 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