Comparative Efficacy of Pregabalin and Ultrasonography-guided Lateral Femoral Cutaneous Nerve Blockage for Meralgia Paresthetica

2017 ◽  
Vol 6 (2) ◽  
pp. 146
Author(s):  
Sibel Okur ◽  
Meltem Vural ◽  
Yasemin Dogan ◽  
Murat Mert ◽  
Nil Caglar
Keyword(s):  
Cutaneous Nerve ◽  
Lateral Femoral Cutaneous Nerve ◽  
Comparative Efficacy ◽  
Meralgia Paresthetica ◽  
Femoral Cutaneous Nerve

The lateral femoral cutaneous nerve canal

2017 ◽  
Vol 126 (3) ◽  
pp. 972-978 ◽  
Author(s):  
Amgad Hanna
Keyword(s):  
Iliac Crest ◽  
Intraoperative Imaging ◽  
Femoral Nerve ◽  
Anatomical Variations ◽  
Cutaneous Nerve ◽  
Lateral Femoral Cutaneous Nerve ◽  
Nerve Transection ◽  
Meralgia Paresthetica ◽  
Anterolateral Thigh ◽  
Femoral Cutaneous Nerve

OBJECTIVE Meralgia paresthetica causes dysesthesias and burning in the anterolateral thigh. Surgical treatment includes nerve transection or decompression. Finding the nerve in surgery is very challenging. The author conducted a cadaveric study to better understand the variations in the anatomy of the lateral femoral cutaneous nerve (LFCN). METHODS Twenty embalmed cadavers were used for this study. The author studied the LFCN's relationship to different fascial planes, and the distance from the anterior superior iliac spine (ASIS). RESULTS A complete fascial canal was found to surround the nerve completely in all specimens. The canal starts at the inguinal ligament proximally and follows the nerve beyond its terminal branches. The nerve could be anywhere from 6.5 cm medial to the ASIS to 6 cm lateral to the ASIS. In the latter case, the nerve may lodge in a groove in the iliac crest. Other anatomical variations found were the LFCN arising from the femoral nerve, and a duplicated nerve. A thick nerve was found in 1 case in which it was riding over the ASIS. CONCLUSIONS The variability in the course of the LFCN can create difficulty in surgical exposure. The newly defined LFCN canal renders exposure even more challenging. This calls for high-resolution pre- or intraoperative imaging for better localization of the nerve.

scholarly journals Transposition of the lateral femoral cutaneous nerve

2019 ◽  
Vol 130 (2) ◽  
pp. 496-501 ◽  
Author(s):  
Amgad Hanna
Keyword(s):  
Rating Scale ◽  
Case Series ◽  
Numeric Rating Scale ◽  
Cutaneous Nerve ◽  
Lateral Femoral Cutaneous Nerve ◽  
Meralgia Paresthetica ◽  
Femoral Cutaneous Nerve ◽  
Simple Decompression ◽  
Reoperation Rates ◽  
Numeric Rating

OBJECTIVEMeralgia paresthetica causes pain, burning, and loss of sensation in the anterolateral thigh. Surgical treatment traditionally involves neurolysis or neurectomy of the lateral femoral cutaneous nerve (LFCN). After studying and publishing data on the anatomical feasibility of LFCN transposition, the author presents here the first case series of patients who underwent LFCN transposition.METHODSNineteen patients with meralgia paresthetica were treated in the Department of Neurological Surgery at University of Wisconsin between 2011 and 2016; 4 patients underwent simple decompression, 5 deep decompression, and 10 medial transposition. Data were collected prospectively and analyzed retrospectively. No randomization was performed. The groups were compared in terms of pain scores (based on a numeric rating scale) and reoperation rates.RESULTSThe numeric rating scale scores dropped significantly in the deep-decompression (p = 0.148) and transposition (p < 0.0001) groups at both the 3- and 12-month follow-up. The reoperation rates were significantly lower in the deep-decompression and transposition groups (p = 0.0454) than in the medial transposition group.CONCLUSIONSBoth deep decompression and transposition of the LFCN provide better results than simple decompression. Medial transposition confers the advantage of mobilizing the nerve away from the anterior superior iliac spine, giving it a straighter and more relaxed course in a softer muscle bed.

Lateral Femoral Cutaneous Nerve Radiofrequency Ablation for Long-term Control of Refractory Meralgia Paresthetica

Pain Medicine ◽  
2020 ◽  
Vol 21 (7) ◽  
pp. 1433-1436
Author(s):  
Alaa Abd-Elsayed ◽  
Michael J Gyorfi ◽  
Sung P Ha
Keyword(s):  
Radiofrequency Ablation ◽  
Abdominal Cavity ◽  
Case Series ◽  
Cutaneous Nerve ◽  
Lateral Femoral Cutaneous Nerve ◽  
Meralgia Paresthetica ◽  
Pain Scores ◽  
Femoral Cutaneous Nerve ◽  
Average Pain

Abstract Background Meralgia paresthetica is a term used to describe a clinical pain syndrome related to the compression or irritation of the lateral femoral cutaneous nerve (LFCN). The LFCN is a pure sensory nerve that is susceptible to compression injury. The most common compression locations are: as it courses from the lumbosacral plexus, through the abdominal cavity, under the inguinal ligament, and into the subcutaneous tissue of the thigh. Methods This case series is a retrospective single-center review of six patients with medically intractable meralgia paresthetica who were treated with radiofrequency ablation. To be considered for radiofrequency ablation, the patient must have been unsuccessful with medical management alone for more than two months and have a clinical diagnosis of meralgia paresthetica. Temporary relief of pain of 50% or greater was considered a positive result. Average pain scores were measured pre- and postprocedure, along with one-, two-, three-, and six-month intervals postoperation. Results All patients demonstrated immediate relief in self-reported pain scores, averaging a 75.5% reduction in pain. At the one-, two-, three-, and six-month follow-ups, patients averaged a reduction of 60.0%, 58.0%, 51.4%, and 40.5%, respectively. Both the postop and one-month follow-up pain scores were lower, statistically significantly so (P &lt; 0.05), whereas the two-, three-, and six-month follow-ups were not statistically different from pretreatment scores. Conclusions Although our study was small, radiofrequency ablation showed a clear reduction in average pain scores in a subset of patients who had failed standard medical therapy with a reduction in pain at one-month follow-up with relief of symptoms sometimes lasting longer than 12 months.

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