Anatomic Study of the Superior Cluneal Nerve and Its Related Groove on the Iliac Crest.

OBJECTIVE: Superior cluneal nerve entrapment neuropathy is one cause of low back pain often referred to as "pseudo sciatica." Studies have found that the superior cluneal nerve can arise variably from T11 to L5. The osteofibrous tunnels formed by a groove on the iliac crest might compress the superior cluneal nerve. Therefore, the purpose of this study was to investigate the origin of the superior cluneal nerve and its course through such bony grooves.

METHODS: Twenty sides from 10 fresh frozen Caucasian cadavers were used in this study. Once both the superior cluneal nerve and its groove were identified, the distance from the groove to the posterior superior iliac spine and midline was measured.

RESULTS: A total of 12 grooves were identified in 11 of 20 sides (55%). On 10 sides, the nerve running on the groove was the medial branch of the superior cluneal nerve. The mean distance from the bony groove to the posterior superior iliac spine and midline was 45.2 ± 11.2 mm and 65.3 ± 8.2 mm, respectively.

CONCLUSIONS: These results could help identify such bony grooves and better understand low back pain and its related anatomy.