Injury to the Lateral Femoral Cutaneous Nerve During Minimally Invasive Hip Surgery: A Cadaver Study

Jameson, Simon; Howcroft, Daniel; McCaskie, Andrew W.; Gerrand, Craig

doi:10.1308/003588408x261618

Cited by 8 publications

(3 citation statements)

References 29 publications

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“…With the anterior approach offering the least damage to a patient’s hip function, the loss of sensation provided by the LFCN becomes a larger concern. Current suggestions for minimally invasive anterior approaches suggest incisions running parallel to the LFCN [ 37 ]. Again, in order for this approach to be viable and the LFCN preserved, the location of the LFCN must be strictly determined, not simply estimated due to the high variability.…”

Section: Discussionmentioning

confidence: 99%

The surgical anatomy of the lateral femoral cutaneous nerve in the inguinal region: a meta-analysis

Tomaszewski

Popieluszko

Henry

et al. 2016

Hernia

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PurposeSeveral variations in the anatomy and injury of the lateral femoral cutaneous nerve (LFCN) have been studied since 1885. The aim of our study was to analyze the available data on the LFCN and find a true prevalence to help in the planning and execution of surgical procedures in the area of the pelvis, namely inguinal hernia repair.MethodsA search of the major medical databases was performed for LFCN anatomy. The anatomical data were collected and analyzed.ResultsTwenty-four studies (n = 1,720) were included. The most common pattern of the LFCN exiting the pelvis was medial to the Sartorius as a single branch. When it exited in this pattern, it did so on average 1.90 cm medial to the anterior superior iliac spine (ASIS).ConclusionsThe LFCN and its variations are important to consider especially during inguinal hernia repair, abdominoplasty, and iliac bone grafting. We suggest maintaining a distance of 3 cm or more from the ASIS when operating to prevent injury to the LFCN.Electronic supplementary materialThe online version of this article (doi:10.1007/s10029-016-1493-7) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

The surgical anatomy of the lateral femoral cutaneous nerve in the inguinal region: a meta-analysis

Tomaszewski

Popieluszko

Henry

et al. 2016

Hernia

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“…3). Recentemente, con lo sviluppo di tecniche operatorie mini-invasive nella protesizzazione dell'anca o con il trattamento dell'impingement femoro-acetabolare per via artrotomica o artroscopica, sono stati riportati numerosi casi di sindrome compressiva del nervo femoro-cutaneo laterale, come complicanza operatoria [8][9][10][11][12][13]. Matsuda e coll.…”

Section: Eziopatogenesiunclassified

La meralgia parestetica

Fischer

Giampaolo

Fontana

2011

LO SCAL

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DefinizioneLa meralgia parestetica è una sindrome clinica dovuta all'intrappolamento e alla compressione del nervo femoro-cutaneo laterale in corrispondenza del legamento inguinale. In generale le neuropatie da intrappolamento si verificano quando un nervo periferico viene compresso in corrispondenza di un canale anatomico a causa di un processo meccanico, infiammatorio e traumatico. Nel caso della meralgia parestetica, comunque, la causa della patologia e dei sintomi non è necessariamante limitata alla compressione del nervo [1,2]. AnatomiaIl nervo femoro-cutaneo laterale origina dalla seconda e terza radice lombare, ma comprende occasionalmente anche qualche fibra della prima radice lombare. Si tratta di un nervo totalmente sensitivo e autonomo. Emerge dal bordo laterale del muscolo ileopsoas, decorre orizzontalmente nella pelvi, insieme alle fibre del muscolo iliaco, fino a un punto appena mediale alla spina iliaca antero-superiore. A questo livello il nervo penetra il legamento inguinale e inizia la sua discesa verticale nella coscia. A circa 3 o 4 centimetri dal suo punto di fuoriuscita dal legamento inguinale, il nervo si divide poi in una branca anteriore e una posteriore (Fig. 1). ABSTRACT -PARESTHESIC MERALGIA The lateral cutaneous femoral nerve is a completely sensitive nerve of the lumbar plexus (L1-3). It emerges from the lateral border of the psoas major at about its middle, and crosses the iliacus muscle obliquely, toward the anterior superior iliac spine (ASIS). It then passes under the inguinal ligament and over the sartorius muscle into the thigh, where it divides into two branches.During it's course, but mostly close to the ASIS, the nerve can be injured or compressed, provoking the typical symptoms of meralgia parestetica: anesthesia or ipoesthesia of the lateral thigh and gluteal region, pain or paresthesia. Prognosis is widely favorable, however farmacological or surgical treatment can be useful in some cases. AggiornamentiFig. 1 -Passaggio del nervo femoro-cutaneo laterale a livello della SIAS sotto al legamento inguinale.A circa 3 o 4 centimetri dal suo punto di fuoriuscita dal legamento inguinale, si divide poi in due branche

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“…보 행 속도, 보폭 그리고 근력 검사 등의 기능적 평가에서도 유의한 차이를 보이지 않았거나, 차이를 보이더라도 1년 이 경과하면 차이가 없어진다고 한다 25,30,56) . cosmesis & ultra-short-term result : minor priority Chen DW 11) increased blood loss & more complication De Beer 13) O Fehring TK 17) more complication Goldstein WM 19) O Hungerford DS 24) problem in introduction Huo MH 25) O Jameson SS 27) more complication Mahmood A 32) only significant in hospital day O Noble PC 40) increased wound edge pressure by retractor Ogonda L 41) O Parvizi J 44) more complication, need learning curve Pilot P 45) O Pour AE 46) O Waldman BJ 55) problem in introduction 장기간의 고관절 탈구, 재치환술 그리고 근위 대퇴골의 전 이성 종양 등이 포함된다 4 5,8, 51,55,57) . 24,55) .…”

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Minimally Invasive Total Hip Arthroplasty

Song

Lee

2009

J Korean Hip Soc

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단일 절개 전방 도달법 (Single incision anterior approach)환자를 앙와위로 위치시키고 전상장골극에서 2 cm 하 방 그리고 2 cm 측방에서 6~9 cm의 피부 절개를 가한다. (Fig. 2). Minimally invasive surgeries, such as laparoscopic, endoscopic and,arthroscopic surgery are currently being used throughout the world. The field of total hip arthroplasty has over 40 years of experience, and minimally invasive total hip arthtoplasty was introduced to reduce the perioperative morbidities. The advocates for minimally invasive total hip arthroplasty will point out the advantages of reduced pain and early ambulation after the operation because of the minimal soft tissue injury. However, we have to review the advantages and disadvantages of minimally invasive total hip arthroplasty to prevent anyharmful effects of this procedure for the patients who under go it.

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Injury to the Lateral Femoral Cutaneous Nerve During Minimally Invasive Hip Surgery: A Cadaver Study

Cited by 8 publications

References 29 publications

The surgical anatomy of the lateral femoral cutaneous nerve in the inguinal region: a meta-analysis

The surgical anatomy of the lateral femoral cutaneous nerve in the inguinal region: a meta-analysis

La meralgia parestetica

Minimally Invasive Total Hip Arthroplasty

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