Superior Cluneal Nerve Injection

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Please use your clinical judgement and note that this is not necessarily standard practice in NZ.

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Superior Cluneal Nerve Injection
Indication	Cluneal nerve pain
Syringe	10mL
Needle	80mm nerve block needle
Steroid	optional
Local	doctor choice
Volume	?10-15mL

Technique

SCN block. The needle is inserted through the thoracolumbar fascia (yellow line), close to the lateral edge of iliocostalia, at the L3 level.
© American Society of Regional Anesthesia & Pain Medicine 2019

The needle is inserted in plane from a lateral to medial direction through the thoracolumbar fascia (yellow line). Intermuscular aponeurosis is shown (red arrow).
© American Society of Regional Anesthesia & Pain Medicine 2019

Injection can be done by landmark guided palpation based on the maximal area of tenderness, and/or by ultrasound guidance.

Ultrasound Guided

An ultrasound guided technique has been developed, in a cadaveric and live human randomised study.