DERLEMELER
Bel Ağrısının Göz Ardı Edilen Nedenlerinden Biri: Superior Kluneal Sinir Tuzaklanma Nöropatisi
One of the Overlooked Causes of Low Back Pain: Superior Cluneal Nerve Entrapment Neuropathy
Received Date : 27 Nov 2019
Accepted Date : 19 Dec 2019
Available Online : 20 Jan 2020
Hatice Rana ERDEMa, Fatmanur Aybala KOÇAKb, Senem ŞAŞc
aYüksek İhtisas Üniversitesi Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon ABD, Ankara, TÜRKİYE
bAhi Evran Üniversitesi Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon ABD, Kırşehir, TÜRKİYE
cErciyes Üniversitesi Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon ABD, Romatoloji BD, Kayseri, TÜRKİYE
Doi: 10.31609/jpmrs.2019-72560 - Makale Dili: TR
J PMR Sci. 2020;23(1):41-7
ÖZET
Bel ağrısı, bireylerin fonksiyonel aktivite düzeyinde büyük bir
etkiye sahip önemli bir sağlık problemidir. Superior kluneal sinir tuzaklanma
nöropatisi (SKSTN), bel ağrısında nedensel faktörlerden biridir.
SKSTN’nin bel ağrısına yol açtığını tanımlayan çeşitli anatomik
ve klinik çalışmalar mevcuttur. Bu durumun klinik özellikleri ve nedenleri
iyi anlaşılmamıştır. Lomber spinal hastalık olarak yanlış tanı almaya
yatkındır.Bel ağrılı hastalarda SKSTN’nin insidansı umulmadık
biçimde yüksektir ve superior kluneal sinir rahatsızlığı olan hastaların
takriben %50’si bacak semptomlarına sahiptir. Şiddetli semptomlara
rağmen tanıları güç olabilir. Tuzaklanma bölgesinde tetik noktanın tanımlanması
ve sinir bloğundan sonra semptomların kaybolması tanısal
olarak önemlidir. SKSTN’ye bağlı bel ağrısı, sinir bloğu veya nöroliz
ile tedavi edilebilir. Fiziyatristler ve spinal cerrahlar, bel ağrısında
SKSTN’nin rolü hakkında yeteri kadar farkında olmadıklarından, biz
bir literatür derlemesi sunduk ve bu genel klinik antitenin tanı ve tedavisini
gözden geçirdik.
Anahtar Kelimeler: Bel ağrısı; superior kluneal sinir; superior kluneal sinir tuzaklanma nöropatisi
ABSTRACT
Low back pain (LBP) is a major health problem that
can have a profound effect on an individual’s level of functional activity.
Superior cluneal nerve entrapment neuropathy (SCNEN) is
one of the causative factors in LBP. There are several anatomical and
clinical studies describing that entrapment of the superior cluneal
nerve produces LBP. Its clinical features and causes are poorly understood.
It tends to be misdiagnosed as lumbar spine disorder. The
incidence of SCNEN in patients with LBP is unexpectedly high and
approximately 50% of superior cluneal nerve disorder patients had
leg symptoms. Despite severe symptoms, their diagnosis can be difficult.
The identification of the trigger point at the entrapment site
and the disappearance of symptoms after nerve block are diagnostically
important. LBP due to SCNEN can be treated by nerve block injection
or neurolysis. As physiatrist and spinal surgeons are not
sufficiently aware of the role SCNEN in LBP, we presented a review
of the literature and reviewed the diagnosis and treatment of this
common clinical entity.
Keywords: Low back pain; superior cluneal nerve; superior cluneal nerve entrapment neuropathy
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