Superior Cluneal Nerve Radiofrequency Ablation for Chronic Low Back and Buttock Pain: A Technical Description and Case Series of Three Patients.

BACKGROUND: Superior cluneal nerve (SCN) entrapment is an underrecognized cause of low back and buttock pain, often mimicking sacroiliac joint or lumbar spine pathology. There is limited literature describing outcomes following radiofrequency ablation (RFA) of the SCN. Case Series: We present three patients with chronic low back and buttock pain refractory to conservative and interventional therapies. All patients underwent diagnostic superior cluneal nerve blocks with 2.5 mL of 0.5% bupivacaine followed by RFA using a bipolar technique along the iliac crest. RFA was performed at 80°C for 90 seconds, with needles repositioned to create a continuous strip lesion. At 2-4 week follow-up, patients reported 65-90% pain relief.

CONCLUSION: SCN RFA using a bipolar strip lesion technique along the iliac crest may provide significant pain relief in patients with refractory low back and buttock pain. Larger studies are needed to validate these findings.