Long-term outcome after surgery for middle cluneal nerve entrapment neuropathy.
Acta Neurochir (Wien)
; 165(9): 2567-2572, 2023 09.
Article
en En
| MEDLINE
| ID: mdl-37481475
ABSTRACT
PURPOSE:
Entrapment of the middle cluneal nerve (MCN-E) can elicit low back pain (LBP). Patients whose LBP responds only transiently to the analgesic effects of MCN blockage may be candidates for surgery. This study addresses its long-term efficacy.METHODS:
We initially subjected 34 MCN-E patients (48 sides) to surgical release. Of these, 4 were excluded from this study because their follow-up was shorter than 24 months. The mean age of the 30 included patients was 71.5 years; the mean postoperative follow-up period was 40.4 months. Clinical outcomes were assessed on the Numerical Rating Scale (NRS) for LBP and the Roland Morris Disability Questionnaire (RDQ) before surgery and at the latest follow-up visit.RESULTS:
The 30 patients (44 sides) reported severe LBP, leg symptoms were elicited by 32 sides. A mean of 1.4 MCN branches were surgically released, 32 sides were addressed by neurolysis, 7 by neurectomy, and 5 underwent both procedures due to the presence of 2 nerve branches. There were no complications. In the course of a mean follow-up of 26.3 months, MCN-E elicited recurrent symptoms on 6 sides; all had undergone neurolysis or neurectomy and a second operation improved the symptoms. All patients showed significant improvement at the last follow-up visit. Postoperatively both their NRS for LBP and their RDQ scores were improved (pre- vs. postoperative scores, p < 0.05).CONCLUSIONS:
While surgical release of MCN-E is expected to yield long-term symptom relief, on 6 of 32 sides (18.8%) treated by neurolysis the patients reported pain recurrence. Whether neurectomy effectively prevents the recurrence of MCN-E in the long term requires further study.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Dolor de la Región Lumbar
/
Síndromes de Compresión Nerviosa
Tipo de estudio:
Etiology_studies
Límite:
Aged
/
Humans
Idioma:
En
Revista:
Acta Neurochir (Wien)
Año:
2023
Tipo del documento:
Article
País de afiliación:
Japón