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Published on: October 20, 2021
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Superior Cluneal Neuralgia Treated With Wireless Peripheral Nerve Stimulation
Gaurav Chauhan1, Isaiah Levy2, David DeChellis3
1Anesthesiology and Perioperative Medicine, University of Pittsburgh Medical Center Presbyterian, Pittsburgh, USA.
Cureus
|May 5, 2022
Summary
Superior cluneal neuralgia (SCN) is often misdiagnosed in low back pain (LBP) patients. This case highlights SCN diagnosis and successful treatment with peripheral nerve stimulation (PNS) after other interventions failed.
Area of Science:
- Pain Medicine
- Neurology
- Surgical Innovation
Background:
- Low back pain (LBP) presents a diagnostic challenge, with neuropathic causes like superior cluneal neuralgia (SCN) frequently overlooked.
- SCN pathomechanics include direct injury or myofascial compression, complicating LBP evaluation.
Observation:
- A 65-year-old male presented with chronic LBP post-laminectomy, initially misdiagnosed and unresponsive to other treatments.
- Retained hardware and fibrosis following laminectomy were noted complications contributing to the patient's pain.
Findings:
- Diagnostic nerve blocks confirmed SCN, providing significant pain relief and guiding further treatment.
- Successful peripheral nerve stimulation (PNS) trial and implantation resulted in long-term pain reduction for the patient.
Implications:
- This case underscores the importance of considering SCN in the differential diagnosis of persistent LBP, especially post-spinal surgery.
- Peripheral nerve stimulation (PNS) offers a viable and effective therapeutic option for refractory superior cluneal neuralgia (SCN).
- Improved diagnostic strategies and targeted treatments like PNS can enhance outcomes for patients with complex LBP etiologies.
