Previous authors have described the anatomy of the superior cluneal nerves with medial, intermediate, and lateral branches as they pass over the iliac crest. Prior authors describe a technique for radiofrequency of the superior cluneal nerves with needle placement walking off of the superior border of the iliac crest with needle redirection by sensory testing and a monopolar radiofrequency lesion. This is a case report of a patient with sustained pain relief after performing a radiofrequency ablation of the superior cluneal nerves utilizing a bipolar palisade technique.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11536287PMC
http://dx.doi.org/10.1016/j.inpm.2024.100425DOI Listing

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Background: Low back pain is a highly prevalent condition with substantial costs. Superior cluneal neuralgia is present in up to 14% of low back pain cases. This etiology of back pain is often overlooked because the symptoms of superior cluneal neuralgia manifest similarly to those of other conditions, such as radiculopathy and sacroiliac joint pain.

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Previous authors have described the anatomy of the superior cluneal nerves with medial, intermediate, and lateral branches as they pass over the iliac crest. Prior authors describe a technique for radiofrequency of the superior cluneal nerves with needle placement walking off of the superior border of the iliac crest with needle redirection by sensory testing and a monopolar radiofrequency lesion. This is a case report of a patient with sustained pain relief after performing a radiofrequency ablation of the superior cluneal nerves utilizing a bipolar palisade technique.

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Introduction: Chronic low back pain is a highly prevalent condition with multiple etiologies. Cluneal nerve neuropathy is an increasingly relevant condition in the management of this condition, and radiofrequency is an alternative management option.

Methods: A case series, which included four patients who underwent ultrasound-guided conventional radiofrequency intervention of the superior cluneal nerves, using a previously undescribed technique and direction of intervention.

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