Page 33 - Read Online

Kim et al. Mini-invasive Surg 2017;1:43-51 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2017.05
www.misjournal.net
Topic: Percutaneous endoscopic system for spinal diseases Open Access

Common diseases mimicking lumbar disc

herniation and their treatment

Kyongsong Kim , Toyohiko Isu , Daijiro Morimoto , Naotaka Iwamoto , Rinko Kokubo , Juntaro Matsumoto , Takao
1
2
3
2
1
4
Kitamura , Atsushi Sugawara , Akio Morita
3
5
3
1 Department of Neurosurgery, Chiba Hokuso Hospital, Nippon Medical School, Inzai-city, Chiba 270-1694, Japan.
2 Department of Neurosurgery, Kushiro Rosai Hospital, Kushiro-city, Hokkaido 085-0088, Japan.
3 Department of Neurosurgery, Nippon Medical School, Bunkyo-ku, Tokyo 113-8603, Japan.
4 Department of Neurosurgery, Teikyo University, Itabashi-ku, Tokyo 173-8606, Japan.
5 Department of Neurosurgery, Iwate Medical University, Morioka-city, Iwate 020-8505, Japan.
Correspondence to: Dr. Kyongsong Kim, Department of Neurosurgery, Chiba Hokuso Hospital, Nippon Medical School, 1715, Kamagari, Inzai-city,
Chiba 270-1694, Japan. E-mail: kyongson@nms.ac.jp
How to cite this article: Kim K, Isu T, Morimoto D, Iwamoto N, Kokubo R, Matsumoto J, Kitamura T, Sugawara A, Morita A. Common diseases
mimicking lumbar disc herniation and their treatment. Mini-invasive Surg 2017;1:43-51.
ABSTRACT
Article history: Lumbar disc herniation (LDH) is a common disease characterized by leg pain, numbness, and
Received: 22-02-2017 low back pain, which are also encountered in peripheral nerve and paralumbar spine disease.
Accepted: 14-03-2017 This study describes other diseases with symptoms similar to LDH. Patients with paralumbar
Published: 30-06-2017 spine diseases such as superior cluneal nerve entrapment neuropathy (NEN), gluteus medius
muscle pain, piriformis syndrome, and sacroiliac joint pain experience lowback, buttock,
Key words: and leg pain. Peripheral nerve diseases of the leg including lateral femoral cutaneous NEN,
Entrapment neuropathy, common and superficial peroneal NEN, and tarsal tunnel syndrome also cause leg symptoms.
peripheral nerve, These diseases can produce intermittent claudication, thought to be specific to lumbar spine
neurolysis, disease, and can be misdiagnosed as LDH. They are rather common and can be treated less
diagnosis, invasively. As a misdiagnosis may result in failed back-surgery syndrome, it is important to
treatment, differentiate between LDH and the diseases described here.
paralumbar spine disease

INTRODUCTION PARA-LUMBAR SPINE DISEASES
Lumbar disc herniation (LDH) is common; its Superior cluneal nerve entrapment neuropathy
symptoms of leg pain, numbness, and lowback pain Definition and symptoms
(LBP), are also reported by patients with peripheral
nerve and paralumbar spine diseases. Since they can The superior cluneal nerve (SCN) is a sensory nerve
cause intermittent claudication, thought to be specific that originates from the lower thoracic and lumbar
to lumbar spine disease, differential diagnosis can posterior nerve. It is comprised of 4 to 6 nerves, runs
be difficult. As misdiagnosis can result in failed back around the paraspinal muscle, penetrates the thoraco-
surgery syndrome (FBSS), spinal surgeons must be lumbar fascia near the iliac crest, and ends at the
able to differentiate them from LDH. buttock [Figure 1]. The clinical features and etiology

Quick Response Code:
This is an open access article licensed under the terms of Creative Commons Attribution 4.0 International
License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution,
and reproduction in any medium, as long as the original author is credited and the new creations are licensed under the
identical terms.
For reprints contact: service@oaepublish.com

© 2017 OAE Publishing Inc. www.oaepublish.com 43