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Robbert C Maatman,1 Oliver B Boelens,2 Marc RM Scheltinga,1 Rudi MH Roumen1 1SolviMáx, Center of Expertise for ACNES, Center of Excellence for Chronic Abdominal Wall and Groin Pain, Department of Surgery, Máxima Medical Center, Veldhoven, The Netherlands; 2Department of Surgery,Maasziekenhuis Pantein, Boxmeer, TheNetherlands Introduction and aim: Chronic back pain (CBP) may be caused by a variety of conditions including dysfunctional muscles, ligaments or intervertebral discs, improper movement of vertebral column joints, or nerve root compression. Recently, CBP was treated successfully in a patient having an entrapment of cutaneous branches of the posterior rami of the thoracic nerves, termed posterior cutaneous nerve entrapment syndrome (POCNES). Our aim is to describe clinical presentation, differential diagnosis, and management of patients with such a neuropathic pain syndrome. Methods: This study analyzed prospectively obtained data from consecutive patients suspected of having POCNES, presenting to two Dutch hospitals between January 2013 and September 2016. Patients received a diagnostic 2–5 mL 1% lidocaine injection just below the thoracolumbar fascia. Pain was scored using a numerical rating scale (0 = no pain to 10 = worst possible pain). A >50% pain reduction was defined as success. A neurectomy was proposed if pain reduction was temporary or insufficient after one to three injections. Long-term treatment effect was determined using a verbal rating scale (VRS; 1 = very satisfied, no pain, to 5 = pain worse). Results: Fourteen patients (12 women, median age 26, age range 18–73) were diagnosed with POCNES. Eighty-one percent (n=11) reported a >50% pain drop after injection (NRS pain scores of median 8.0 [IQR 7.0–8.0] to median 3.0 [IQR 1.5–3.5], P

A patient was referred to SolviMax, our 'centre of excellence for chronic abdominal wall and groin pain' because of persistent inguinodynia after a Lichtenstein repair. A surgical exploration revealed a spermatic cord that was divided by the mesh, supposedly during the primary repair. As a consequence, the patient had developed severe neuropathic pain originating from a damaged genitofemoral nerve. Following a tailored neurectomy, he became pain free.