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Dysfunction of the superior cluneal nerves is often due to entrapment as the nerves cross the iliac crest – this can result in numbness, tingling or pain in the low back and upper buttocks region. Superior cluneal nerve dysfunction is a clinical diagnosis that can be supported by diagnostic nerve blocks. [1]
The cluneal nerves (or clunial nerves) are cutaneous nerves of the buttocks. They are often classified according to where on the buttocks they innervate. Specifically, the nerves are as follows: Superior cluneal nerves; Medial cluneal nerves; Inferior cluneal nerves
Lumboinguinal nerve (green) and Ilioinguinal nerve (purple). In modern texts, these two regions are often considered to be innervated by the genitofemoral nerve. Medial cluneal nerves (pink) - labeled as "post. division of sacral" Inferior cluneal nerves (pink region, not designated with its own section)
The superior cluneal nerves travel through the thoracolumbar fascia and drape over the iliac crest. [5] The posterior branches of the iliohypogastric nerve can emerge on the surface above the iliac crest, with the nerve draping lower than usual in some individuals. [8]
The superior cluneal nerves, middle cluneal nerves, posterior femoral cutaneous nerve, lateral femoral cutaneous nerve are all sensory and resection may simply be a more "complete" option, as nerve decompressions can't explore every part of the nerve and may miss some entrapment points. Outcomes for nerve resection is similar to nerve ...
For this reason, a nerve resection may be considered after a failed decompression. Examples of nerves that may be good candidates for resection are lateral femoral cutaneous nerve, [42] zygomaticotemporal branch of the trigeminal nerve, [43] the posterior femoral cutaneous nerve, [44] [45] and the middle/superior cluneal nerves. [46]
The lateral cutaneous branch ("iliac branch") pierces the internal oblique muscles and the external oblique muscles immediately above the iliac crest. [4] It is distributed to the skin of the gluteal region, behind the lateral cutaneous branch of the subcostal nerve; the size of this branch bears an inverse proportion to that of the lateral cutaneous branch of the subcostal nerve.
Supraclavicular nerves (yellow) Axillary nerve (blue). Also Superior lateral cutaneous nerve of arm. Inferior lateral cutaneous nerve of arm - Near blue "axillary" area, but actually branches from radial nerve. Most modern sources distinguish the superior and inferior, but some still include a single "lateral brachial cutaneous nerve".