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Successful Treatment of Chronic Donor Site Pain.

Yanow JH, Lorenzo LD, Worosilo SC, Pappagallo M - Anesth Pain Med (2015)

Bottom Line: This is a case presentation of a 45-year-old male with chronic donor site pain following autologous iliac crest bone harvest successfully treated with superior cluneal nerve blockade.Donor site pain following autologous iliac crest bone harvest is a common surgical complication that is often resistant to conservative treatments such as physical therapy and oral medications.Blockade of the superior cluneal nerves is a safe and technically simple procedure that may result in long-term pain relief, obviating the need to consider more invasive options.

View Article: PubMed Central - PubMed

Affiliation: The New Jersey Pain Management Institute, Somerset, New Jersey, USA.

ABSTRACT

Introduction: This is a case presentation of a 45-year-old male with chronic donor site pain following autologous iliac crest bone harvest successfully treated with superior cluneal nerve blockade. Donor site pain following autologous bone harvest is a common postoperative complication of lumbar fusion procedures that can cause significant morbidity and diminish quality of life, even in the context of an otherwise successful surgery. Dysfunction of the superior cluneal nerves is an etiology of this chronic pain. The patient's medical history, attempted treatments, and literature were reviewed.

Case presentation: A 45-year-old male with a six year history of severe pain over the right iliac crest following an otherwise successful lumbar laminectomy and fusion underwent two sets of superior cluneal nerve blocks, with sustained relief of more than 80% at seven months follow up.

Conclusions: Donor site pain following autologous iliac crest bone harvest is a common surgical complication that is often resistant to conservative treatments such as physical therapy and oral medications. Blockade of the superior cluneal nerves is a safe and technically simple procedure that may result in long-term pain relief, obviating the need to consider more invasive options.

No MeSH data available.


Related in: MedlinePlus

Positioning of the Three Spinal Needles Overlying the Branches of the Superior Cluneal Nerves as They Pass Over the Right Iliac Crest
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fig21294: Positioning of the Three Spinal Needles Overlying the Branches of the Superior Cluneal Nerves as They Pass Over the Right Iliac Crest

Mentions: Under fluoroscopy, the right PSIS was identified. The skin overlying the assumed location of the three superior cluneal nerves was marked, at distances of 5 cm, 6.5 cm and 7.3 cm from the PSIS (4-6). After anaesthetizing the skin with 1% lidocaine, a 22 gauge 3.5 cm spinal needle was inserted until contact was made with the iliac crest (Figure 1). It was repeated at each of the three locations, and then a total of 1 mL of kenalog, 1 mL of 1% lidocaine and 1 mL of 0.25% marcaine was injected in divided doses. The needles were withdrawn and no complications were reported during or after the procedure.


Successful Treatment of Chronic Donor Site Pain.

Yanow JH, Lorenzo LD, Worosilo SC, Pappagallo M - Anesth Pain Med (2015)

Positioning of the Three Spinal Needles Overlying the Branches of the Superior Cluneal Nerves as They Pass Over the Right Iliac Crest
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4644311&req=5

fig21294: Positioning of the Three Spinal Needles Overlying the Branches of the Superior Cluneal Nerves as They Pass Over the Right Iliac Crest
Mentions: Under fluoroscopy, the right PSIS was identified. The skin overlying the assumed location of the three superior cluneal nerves was marked, at distances of 5 cm, 6.5 cm and 7.3 cm from the PSIS (4-6). After anaesthetizing the skin with 1% lidocaine, a 22 gauge 3.5 cm spinal needle was inserted until contact was made with the iliac crest (Figure 1). It was repeated at each of the three locations, and then a total of 1 mL of kenalog, 1 mL of 1% lidocaine and 1 mL of 0.25% marcaine was injected in divided doses. The needles were withdrawn and no complications were reported during or after the procedure.

Bottom Line: This is a case presentation of a 45-year-old male with chronic donor site pain following autologous iliac crest bone harvest successfully treated with superior cluneal nerve blockade.Donor site pain following autologous iliac crest bone harvest is a common surgical complication that is often resistant to conservative treatments such as physical therapy and oral medications.Blockade of the superior cluneal nerves is a safe and technically simple procedure that may result in long-term pain relief, obviating the need to consider more invasive options.

View Article: PubMed Central - PubMed

Affiliation: The New Jersey Pain Management Institute, Somerset, New Jersey, USA.

ABSTRACT

Introduction: This is a case presentation of a 45-year-old male with chronic donor site pain following autologous iliac crest bone harvest successfully treated with superior cluneal nerve blockade. Donor site pain following autologous bone harvest is a common postoperative complication of lumbar fusion procedures that can cause significant morbidity and diminish quality of life, even in the context of an otherwise successful surgery. Dysfunction of the superior cluneal nerves is an etiology of this chronic pain. The patient's medical history, attempted treatments, and literature were reviewed.

Case presentation: A 45-year-old male with a six year history of severe pain over the right iliac crest following an otherwise successful lumbar laminectomy and fusion underwent two sets of superior cluneal nerve blocks, with sustained relief of more than 80% at seven months follow up.

Conclusions: Donor site pain following autologous iliac crest bone harvest is a common surgical complication that is often resistant to conservative treatments such as physical therapy and oral medications. Blockade of the superior cluneal nerves is a safe and technically simple procedure that may result in long-term pain relief, obviating the need to consider more invasive options.

No MeSH data available.


Related in: MedlinePlus