Cluneal nerve release: a systematic review,European Spine Journal

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Cluneal nerve release: a systematic review
European Spine Journal ( IF 2.6 ) Pub Date : 2022-09-26 , DOI: 10.1007/s00586-022-07394-6
Elie Najjar ₁ , Faris Karouni ₁ , Spyridon Komaitis ₁ , Bronek Boszczyk ₁ , Nasir A Quraishi ₁

Affiliation

Background

Despite the heterogeneity of chronic lower back pain aetiologies, cluneal nerve entrapment remains underdiagnosed and poorly understood with few studies discussing the efficacy of its surgical release.

Objective

The current study opts to conduct a systematic review reporting on the efficacy of cluneal nerve surgical decompression in patients with an established diagnosis who fail conservative treatment. We aimed to systematically evaluate the literature regarding the clinical outcomes, recurrence of symptoms and revision rates of surgical intervention.

Methods

A systematic review of the English language literature dating up until May 2022 was undertaken according to the PRISMA guidelines. Isolated case reports were excluded.

Results

Of a total of 54 articles, 4 studies met the inclusion criteria (three were level IV evidence and one level III evidence) and were analyzed. Overall, 98 patients of mean age 61 years, (range 17–86) underwent cluneal nerve release with a mean follow-up of 25.5 months (6–58 months). There was significant improvement in symptoms post operatively in the 4 studies. No systemic or local complications were encountered during the surgeries. Four articles reported on revision surgery for recurrent symptoms in 8 patients out of 98 with a rate of 8.2%. Of the reoperated patients, 7/8 had new branches released that were not addressed initially and 1 had neurectomy for an adhered pre-released branch.

Conclusion

This systematic review demonstrated that cluneal nerve decompression has been performed in a total of 98 patients with significant clinical improvement, zero systemic and local complications and revision rates of 8.2% of the cases.

中文翻译：

臀神经释放：系统评价

背景

尽管慢性下腰痛的病因具有异质性，但由于很少有研究讨论其手术松解的疗效，因此对楔神经卡压的诊断和了解仍然不足。

客观的

目前的研究选择对保守治疗失败的诊断明确的患者进行锁神经手术减压的疗效进行系统评价报告。我们的目的是系统地评估有关临床结果、症状复发和手术干预翻修率的文献。

方法

根据 PRISMA 指南，对截至 2022 年 5 月的英语文献进行了系统回顾。孤立的病例报告被排除在外。

结果

在总共 54 篇文章中，有 4 篇研究符合纳入标准（3 篇为 IV 级证据，1 篇为 III 级证据）并进行了分析。总体而言，98 名平均年龄 61 岁（范围 17-86 岁）的患者接受了臀神经松解术，平均随访 25.5 个月（6-58 个月）。在 4 项研究中，术后症状明显改善。手术过程中未出现全身或局部并发症。4 篇文章报道了 98 例患者中 8 例复发症状的翻修手术，发生率为 8.2%。在再次手术的患者中，7/8 的新分支释放了最初未处理的问题，1 名患者对粘附的预释放分支进行了神经切除术。