• Joe Iwanaga, Emily Simonds, Maia Schumacher, Rod J Oskouian, and R Shane Tubbs.
• Seattle Science Foundation, Seattle, Washington, USA; Division of Gross and Clinical Anatomy, Department of Anatomy, Kurume University School of Medicine, Kurume, Japan. Electronic address: joei@seattlesciencefoundation.org.
• World Neurosurg. 2019 Aug 1; 128: e12-e15.

ObjectiveSuperior cluneal nerve (SCN) entrapment neuropathy can result in low back pain and thus be confused with other pathologies (e.g., lumbar disk disease). Therefore we performed cadaveric dissection of the SCN to better understand its anatomy and segmental origin.MethodsTwenty sides from 10 Caucasian fresh frozen cadavers (6 females and 4 males) were used in this study. The diameter of the SCN, distance between the exit point of the SCN from the thoracolumbar fascia and midline, and distance between the exit point of the SCN from the thoracolumbar fascia and the posterior superior iliac spine to the medial and lateral SCN were measured. The segmental origins of the SCNs were verified.ResultsSeventy-five percent of the dorsal rami of L1, 90% of L2, 95% of L3, 45% of L4, and 10% of L5 contributed to the SCN. The SCN was formed by 3 vertebral levels in 55% and by 4 vertebral levels in 30%. Three SCNs pierced the thoracolumbar fascia in 45%.ConclusionsThe origin of the SCN, which has been described in the textbook and literature for a long time, should be reconsidered on the basis of our study results.Copyright © 2019 Elsevier Inc. All rights reserved.

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