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Posterior Cutaneous Branch of Lumbar Rami

ramus cutaneus posterior rami posterioris lumbalis

The posterior cutaneous branches of the lumbar posterior rami supply the skin of the lower back from L1 to L5. The L1-L3 branches are the superior cluneal nerves, curving over the iliac crest to supply the upper buttock. The L4-L5 posterior cutaneous branches supply skin in the lower lumbar region but do not extend over the iliac crest.

Region: Lower Back

Clinical Relevance

Clinical Notes

Posterior cutaneous lumbar branch entrapment at the thoracolumbar fascia or iliac crest is a cause of posterior low back pain with a cutaneous quality (burning, hypersensitivity). It is distinguished from facet joint pain by the superficial, dermatological nature of the sensory change. Subcutaneous injections along the iliac crest target these branches. The L1-L3 superior cluneal branches are most clinically relevant, entrapable at the posterior iliac crest.

Pathology

Common Injuries & Conditions

Posterior Lumbar Cutaneous Branch Entrapment

Compression of posterior rami cutaneous branches at the thoracolumbar fascia producing superficial lower back burning and hypersensitivity, managed with subcutaneous injection series along the affected dermatome.