PDF(Pubmed)
Abstract：
A rare but typically overlooked diagnosis in the orthopaedic surgery community is superior cluneal nerve (SCN) entrapment syndrome. The cluneal nerves function as purely sensory fibers, and the SCNs provide cutaneous innervation to the posterior parasacral, gluteal, and posterolateral thigh regions. When irritated, this syndrome can cause acute and chronic lower back pain and lower extremity symptoms. A 14-year-old adolescent girl presented to the clinic for an evaluation of pain in the right side of her lower back. The patient\'s physical examination showed tenderness to palpation on the right posterior iliac crest seven centimeters from the midline. Her neurologic examination demonstrated normal deep tendon reflexes, muscle strength, and sensation in the L2-S1 dermatomal distribution. Although imaging showed evidence of a left L5 spondylolysis, she responded positively to a steroid injection over the posterior iliac crest but negatively to one over the L5 pars defect. She later underwent a right SCN decompression surgery. After the procedure, she reported at least 90% improvement in her pain and rated it as a one in severity, on a scale of 0 to 10. Research regarding SCN entrapment syndrome has increased in the past several years. However, most of these studies are limited to the adult population. Therefore, more reports highlighting the potential for this syndrome in adolescents are needed as well.
摘要：
骨科手术界罕见但通常被忽视的诊断是上肌腱神经（SCN）卡压综合征。肘部神经的功能是纯粹的感觉纤维,SCNs为后骶骨提供皮肤神经支配，臀肌,和大腿后外侧区域。当被激怒时，这种综合征可引起急性和慢性下背部疼痛和下肢症状。一名14岁的青春期女孩出现在诊所，以评估她下背部右侧的疼痛。患者的体格检查显示，在距中线7厘米的右后髂关节触诊有压痛。她的神经系统检查显示深肌腱反射正常，肌肉力量,和L2-S1皮肌分布中的感觉。尽管影像学显示有左L5峡部裂的证据，她对髂后骨上的类固醇注射反应积极，但对L5条缺损上的类固醇注射反应消极。她后来接受了右SCN减压手术。手术后,她报告说疼痛至少改善了90%，并将其评为严重程度，在0到10的范围内。在过去的几年中，有关SCN诱捕综合征的研究有所增加。然而,这些研究大多仅限于成年人群。因此,还需要更多的报告强调这种综合征在青少年中的可能性。
