Meralgia Paresthetica: Diagnosis and Treatment

Grossman, Mark G.; Ducey, S.; Nadler, Scott S.; Levy, Andrew

doi:10.5435/00124635-200109000-00007

Cited by 199 publications

(163 citation statements)

References 31 publications

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“…This nerve is at particular risk with other anterior approaches to the hip, such as pelvic osteotomies and iliac crest bone graft harvesting [9,19,28,32,42,43,67]. Although injury to the LFCN does not represent a major neurologic complication as compared with the potentially catastrophic outcomes of sciatic and femoral nerve palsies [4,20,21,23,31,54,55], its incidence after joint arthroplasty through an anterior approach is not well reported [39,49,57,61].…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…The common involvement of the LFCN with anterior approaches to the iliac wing or to the hip is believed to be the result of the wide variability in its regional anatomy [16,28,37,42,46,48,55]. The nerve is particularly variable at the level of the anteroposterior iliac spine and the inguinal ligament [14,16,22,28,48,60]. It is also vulnerable distally as it emerges from the sartorius muscle or through the interval between sartorius and the tensor fascia lata [5,8,38] and then arborizes into the anterior and posterior branches, which supply the cutaneous area of the anterolateral thigh [5,21,43,46].…”

Section: Introductionmentioning

confidence: 99%

“…It is also vulnerable distally as it emerges from the sartorius muscle or through the interval between sartorius and the tensor fascia lata [5,8,38] and then arborizes into the anterior and posterior branches, which supply the cutaneous area of the anterolateral thigh [5,21,43,46]. Consequently, not only can the nerve be injured at various levels, but also through various mechanisms, including stretching, compression, laceration, and involvement in scar tissue formation [15,16,22,28,30,36,44,55,67] (Fig. 1).…”

Section: Introductionmentioning

confidence: 99%

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Incidence of Lateral Femoral Cutaneous Nerve Neuropraxia After Anterior Approach Hip Arthroplasty

Goulding

Beaulé

Kim

et al. 2010

Clinical Orthopaedics &Amp; Related Research

207

145

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Background Although injury to the lateral femoral cutaneous nerve (LFCN) is a known complication of anterior approaches to the hip and pelvis, no study has quantified its' incidence in anterior arthroplasty procedures. Questions/purposes We therefore defined the incidence, functional impact, and natural history of LFCN neuropraxia after an anterior approach for both hip resurfacing (HR) and primary total hip arthroplasty (THA). Methods We followed 132 patients who underwent an anterior hip approach (55 THA; 77 HR). We administered self-reported questionnaires for sensory deficits of LFCN, neuropathic pain score (DN4), visual analog scale, as well as SF-12, UCLA, and WOMAC scores at one year postoperatively. A subset of 60 patients (30 THA; 30 HR) was evaluated at two time intervals. Results One hundred seven patients (81%) reported LFCN neuropraxia with a mean severity score of 2.32/10 and a mean DN4 score of 2.42/10. Hip resurfacing had a higher incidence of neuropraxia as compared with THA: 91% versus 67%, respectively. No functional limitations were reported on SF-12, WOMAC, or UCLA scores. Of the subset of 60 patients followed over an average of 12 months, 53 (88%) reported neuropraxia at the first followup interval with only three (6%) having complete resolution at second followup. Improvement in DN4 scores was observed over time: 3.6 versus 2.5, respectively. Conclusions Although LFCN neuropraxia was a frequent complication after anterior approach THA, it did not lead to functional limitations in our patients. A decrease in symptoms occurred over time but only a small number of patients reported complete resolution. Level of Evidence Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Incidence of Lateral Femoral Cutaneous Nerve Neuropraxia After Anterior Approach Hip Arthroplasty

Goulding

Beaulé

Kim

et al. 2010

Clinical Orthopaedics &Amp; Related Research

207

145

View full text Add to dashboard Cite

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“…10 The condition is characterized by pain or dysesthesia in the lateral thigh in the distribution of the LFCN. 1,3,[5][6][7][8][9][11][12][13][14][15][16] It is mostly unilateral, but 8 -12% of patients experience bilateral symptoms. 6 Electrophysiological studies performed to confirm the diagnosis of an LFCN lesion include LFCN conduction studies and somatosensory evoked potentials (SEPs) recorded from the scalp.…”

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confidence: 99%

Evoked potentials elicited by stimulation of the lateral and anterior femoral cutaneous nerves in meralgia paresthetica

et al. 2003

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Seventy-five consecutive patients with clinical symptoms and signs of meralgia paresthetica underwent bilateral somatosensory evoked potential (SEP) studies involving stimulation of skin areas innervated by the lateral and anterior femoral cutaneous nerves of the thighs. The most common abnormality was an absolute lateral femoral cutaneous SEP latency Ͼ 40 ms in 35 patients (47%), followed by an absent response in 14 patients (19%), an absolute latency Ͻ 40 ms but amplitude reduction Ͼ 50% compared with the contralateral response in 8 patients (11%), and an absolute latency Ͻ 40 ms but Ͼ 5 ms interside latency difference in 5 patients (7%). Anterior femoral cutaneous SEPs were of value in distinguishing meralgia paresthetica from a proximal lumbar radiculopathy in an additional 4 patients and confirming bilateral meralgia paresthetica in 10 patients.

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