Surgical options for meralgia paresthetica: long-term outcomes in 13 cases

Ataızı, Zeki Serdar; Ertilav, Kemal; Ercan, Serdar

doi:10.1080/02688697.2018.1538480

Cited by 11 publications

(11 citation statements)

References 26 publications

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“…Ultimately, a total of 25 articles describing 33 distinct treatment cohorts published between 1988 and 2019 satisfied all criteria for inclusion in our study (Table 1). For treatment by injection, there were 6 retrospective cohorts; 4,[15][16][17][18][19] for treatment by neurolysis, there were 16 retrospective cohorts, 4,16,[20][21][22][23][24][25][26][27][28][29][30][31][32][33] 2 prospective cohorts, 34,35 and 1 randomized cohort; 36 and for treatment by neurectomy, there were 5 retrospective cohorts, 4,23,24,37,38 2 prospective cohorts, 34,35 and 1 randomized cohort. 36…”

Section: Search Strategymentioning

confidence: 99%

Meralgia paresthetica treated by injection, decompression, and neurectomy: a systematic review and meta-analysis of pain and operative outcomes

Burks

Heath

et al. 2021

Journal of Neurosurgery

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OBJECTIVEMeralgia paresthetica is caused by entrapment of the lateral femoral cutaneous nerve (LFCN) and often presents with pain. Multiple treatment options targeting the LFCN can be pursued to treat the pain should conservative measures fail, with the most common options being injection, neurolysis, and neurectomy. However, their efficacy in causing pain relief and their clinical outcomes have yet to be directly compared. The aim of this study was to interrogate the contemporary literature and quantitatively define how these options compare.METHODSThe electronic databases Ovid Embase, PubMed, SCOPUS, and the Cochrane Library were interrogated from inception to May 2020 following the PRISMA guidelines. Candidate articles were screened against prespecified criteria. Outcome data were abstracted and pooled by random-effects meta-analysis of proportions.RESULTSThere were 25 articles that satisfied all criteria, reporting outcomes for a total of 670 meralgia paresthetica patients, with 78 (12%) treated by injection, 496 (74%) by neurolysis, and 96 (14%) by neurectomy. The incidence of complete pain relief was 85% (95% CI 71%–96%) after neurectomy, 63% (95% CI 56%–71%) after neurolysis, and 22% (95% CI 13%–33%) after injection, which were all statistically different (p < 0.01). The incidence of revision procedures was 12% (95% CI 4%–22%) after neurolysis and 0% (95% CI 0%–2%) after neurectomy, which were significantly lower than 81% (95% CI 64%–94%) after injection (p < 0.01). The incidences of treatment complications were statistically comparable across all three treatments, ranging from 0% to 5% (p = 0.34).CONCLUSIONSThere are multiple treatment options to target pain in meralgia paresthetica. The incidence of complete pain relief appears to be the greatest among the 3 interventions after neurectomy, accompanied by the lowest incidence of revision procedures. These findings should help inform patient preference and expectations. Greater exploration of the anatomical rationale for incomplete pain relief after surgical intervention will assist in optimizing further surgical treatment for meralgia paresthetica.

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Section: Search Strategymentioning

confidence: 99%

Meralgia paresthetica treated by injection, decompression, and neurectomy: a systematic review and meta-analysis of pain and operative outcomes

Burks

Heath

et al. 2021

Journal of Neurosurgery

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“…23 Many authors believe that neurectomy is superior to decompression/neurolysis due to better surgical outcomes with no recurrence. [24][25][26]27,28,29 In neurectomy, complete resolution of symptoms are provided by the resection of LFCN, but there is a risk of denervation pain, and it leaves behind an anesthetic area associated with permanent numbness in the anterolateral thigh. 9,23 In addition, in neurectomy procedure, important aberrant pathways of this nerve may cause difficulty in the surgical localization, and femoral nerve can be dissected incorrectly by assuming LFCN.…”

Section: Discussionmentioning

confidence: 99%

“…However, many other studies have reported very good results and high-levels of patient satisfaction. 26,28,[30][31][32][33] Schwaiger et al reported decompression/neurolysis as the primary surgical procedure of choice for the treatment of MP, if the conservative treatment fails. 33 Siu and Chandran reported a series of 45 cases undergoing surgical treatment of MP.…”

Section: Discussionmentioning

confidence: 99%

Decompression and Neurolysis of the Lateral Femoral Cutaneous Nerve in the Surgical Treatment of Meralgia Paresthetica and the Results

Kıbıcı

Erok²,

Atça

2020

Indian Journal of Neurosurgery

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Meralgia paresthetica (MP), also known as Bernhardt–Roth syndrome, is a peripheral neuropathy of the primary sensory lateral femoral cutaneous nerve (LFCN). Its diagnosis is challenging, because it can mimic other clinical conditions particularly associated with upper lumbar spine or pelvis. Patients present with pain and paresthesia over the anterolateral thigh. Diagnosis is usually based on clinical examination and is supported by sensory nerve conduction (SNC) studies. The initial treatment is always conservative. In limited number of patients who are refractory to conservative managements, surgical treatment via decompression/neurolysis or neurectomy is concerned. There is still no consensus on which surgical technique is the best and the first choice. We retrospectively analyzed the surgical outcomes of 12 nonobese patients who underwent decompression/neurolysis between the years 2013 and 2018. Bilateral SNC studies were performed in all cases which supported the diagnosis. We applied conservative treatments for 3 months in addition to the treatments previously applied in other centers. Surgery was recommended for the patients who were refractory to these treatments. Preoperative and postoperative pain levels during follow-up visits were evaluated with visual analogue scale (VAS). A retrospective analysis was performed on preoperative and postoperative 6th month VAS scores. The mean preoperative VAS value was 8.75 ± 0.62 and the postoperative VAS value at the sixth month was 1.17 ± 0.72. A significant reduction in the pain was shown (p < 0.05). Our surgical results showed that decompression/neurolysis of the LFCN should be concerned as the primary surgical approach to avoid negative outcomes of resection surgeries.

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“…La MP es una patología multifactorial y se asocia con factores de riesgo, divididos en 2 grupos: a) idiopáticos (metabólicos o mecánicos) b) iatrogénicos (trauma o cirugía) (1,2,13). La forma idiopática es la más común y aparece tanto en hombres como en mujeres, principalmente en la edad media de la vida.…”

Section: Epidemiologíaunclassified

“…Dentro del subgrupo de factores mecánicos se menciona la obesidad, embarazo, uso de prendas ajustadas, escoliosis, traumatismo directo en el NCFL y condiciones clínicas que aumenten la presión intraabdominal como, por ejemplo, los tumores pélvicos y/o retroperitoneales (1,11). La diabetes mellitus es la principal causa metabólica asociada a la meralgia parestésica, otros factores metabólicos son el alcoholismo y el envenenamiento por plomo (4,13). La neuropatía periférica asociada con el consumo de alcohol es predominantemente axonal y de tipo sensorial de fibras pequeñas, siendo la causa probablemente una deficiencia de tiamina o el efecto tóxico directo del etanol (4).…”

Section: Epidemiologíaunclassified

Meralgia parestésica: manejo y tratamiento

Villalobos

Delgado

Jarquín

2023

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La meralgia parestésica o neuralgia del nervio femorocutáneo es una enfermedad que se caracteriza por parestesias, adormecimiento, debilidad y dolor tipo quemante en la parte externa del muslo. La principal causa es la compresión del nervio cutáneo femoral lateral el cual es un nervio sensitivo puro, que se forma por la unión de las raíces nerviosa de L2-L3 yes el principal encargado de la sensibilidad de la región anterior y la mitad superior de la cara lateral del muslo. Es una enfermedad que afecta predominantemente a pacientes entre los 30 y 40 años con mayor incidencia en el género masculino.En la mayoría de los casos, las causas más frecuentes se deben a obesidad, embarazo, ropa ajustada, así como también, a un traumatismo local o a una enfermedad como la diabetes mellitus. En la mayoría de los casos, el manejo consiste en medidas moderadas, sin embargo, en casos graves el tratamiento puede constar de medicamentos analgésicos y en raras ocasiones, tratamiento quirúrgico.

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Surgical options for meralgia paresthetica: long-term outcomes in 13 cases

Cited by 11 publications

References 26 publications

Meralgia paresthetica treated by injection, decompression, and neurectomy: a systematic review and meta-analysis of pain and operative outcomes

Meralgia paresthetica treated by injection, decompression, and neurectomy: a systematic review and meta-analysis of pain and operative outcomes

Decompression and Neurolysis of the Lateral Femoral Cutaneous Nerve in the Surgical Treatment of Meralgia Paresthetica and the Results

Meralgia parestésica: manejo y tratamiento

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