Superior cluneal nerves

Superior cluneal nerves
Cutaneous nerves of the right lower extremity. Front and posterior views. (Posterior division of lumbar visible in yellow at top right.)
Details
From	posterior branches of the lumbar nerves
Innervates	buttocks
Identifiers
Latin	nervi clunium superiores
TA98	A14.2.05.006
TA2	6493
FMA	75468
Anatomical terms of neuroanatomy

The superior cluneal nerves innervate the skin of the upper part of the buttocks. They are the terminal ends of lateral rami of the posterior rami of lumbar spinal nerves (L1, 2, 3).

Clinicals

Superior Cluneal Nerve Entrapment

The medial branch of the superior cluneal nerve passes over the iliac crest through a tunnel formed by the thoracolumbar fascia and the superior rim of the iliac crest. This branch of the superior cluneal nerve may become restricted in its osteofibrous tunnel against the iliac crest, just as osteofibrous tunnels affect other nerves, such as in carpal tunnel syndrome. The clinical symptoms include pain at low back which may radiate to the ipsilateral leg. The clinical signs include marked tenderness at iliac crest rim just above the dimple at the buttock and decreased touch sensation of the buttock just below the iliac crest. The treatment includes elimination of inappropriate use such as forward bending or acute twisting of the low back, NSAID therapy and local steroid injection. Surgical treatment by nerve decompression is used for cases of severe pain with failure of conservative treatment.

Additional images

• 
  Diagram of the distribution of the cutaneous branches of the posterior divisions of the spinal nerves.
• 
  Areas of distribution of the cutaneous branches of the posterior divisions of the spinal nerves.

References

• Hammer, Warren. 1998. "Superior Cluneal Nerve Entrapment -- An Overlooked Cause of Low Back Pain," Dynamic Chiropractic, 16(10). link
• Lu J, Ebraheim NA, Huntoon M, Heck BE, Yeasting RA (1998). "Anatomic considerations of superior cluneal nerve at posterior iliac crest region". Clin. Orthop. Relat. Res. (347): 224–8. PMID 9520894.

External links

• glutealregion at The Anatomy Lesson by Wesley Norman (Georgetown University)
• Anatomy photo:11:07-0102 at the SUNY Downstate Medical Center - "Superficial Anatomy of the Lower Extremity: Cutaneous Nerves of the Posterior Aspect of the Lower Extremity"