Preoperative Ultrasound-Guided Wire Localization of the Lateral Femoral Cutaneous Nerve

Hanna, Amgad S.; Ehlers, Mark; Lee, Kenneth S

doi:10.1093/ons/opw009

Cited by 19 publications

(9 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although some surgeons may perform and interpret their own US, it can demand valuable operative time, and the US machines typically found in the operating room are not as advanced as those in the radiology department. 15 In our patient, the minimally invasive transtubular approach associated with a CT ACS marking allowed great precision to locate the INS under the rib, its gross total resection, and pleural open avoidance. To our knowledge, this technique has not been previously described.…”

Section: Discussionmentioning

confidence: 75%

Carbon-Assisted Minimally Invasive Transtubular Approach for Intercostal Nerve Schwannoma

Landriel,

Padilla Lichtenberg,

Ulloque-Caamaño

et al. 2023

Operative Neurosurgery

View full text Add to dashboard Cite

BACKGROUND AND OBJECTIVES: The intraoperative localization of an intercostal nerve schwannoma (INS) is extremely difficult because the lesion is generally not palpable, and the fluoroscopic visualization of anatomic landmarks in the ribs is unsatisfactory. Using activated carbon suspension to mark the soft-tissue approach could improve INS localization. We present a novel, simple, reproducible carbon-assisted minimally invasive transtubular approach for an INS. METHODS: The patient was a 57-year-old man with a painful 12th left INS arising below the floating rib. A computed tomography image–guided, tumor-to-skin marking with aqueous carbon suspension was performed 48 hours before surgery. A minimally invasive transtubular approach following the carbon path allowed a precise tumor location. RESULTS: The INS was completely removed. The patient's thoracic radicular pain was immediately relieved after surgery. He was discharged the following day with residual numbness on the left thoracic side. At the 5-year follow-up, no tumor recurrence was noted in the control MRI. CONCLUSION: This article presents an alternative novel technique for resecting an intercostal schwannoma. Using a transtubular approach with carbon-marking assistance allowed a tumor gross total resection with immediate pain relief and a successful outcome.

show abstract

Section: Discussionmentioning

confidence: 75%

Carbon-Assisted Minimally Invasive Transtubular Approach for Intercostal Nerve Schwannoma

Landriel,

Padilla Lichtenberg,

Ulloque-Caamaño

et al. 2023

Operative Neurosurgery

View full text Add to dashboard Cite

show abstract

“…Although ultrasound has proven to be increasingly successful for noninvasive peripheral nerve visualization and for assessment of the fan type versus non-fan type of LCFN prior to total hip arthroplasty [11], to our knowledge, preoperative noninvasive ultrasound localization of the LFCN prior to decompressive surgery has not yet been described. Preoperative ultrasound-guided wire localization has been reported with preliminary feasibility; however, the approach is more invasive than using the high-resolution ultrasound alone, as the wire is placed around the nerve and the patient must be under anesthesia [12].…”

Section: Discussionmentioning

confidence: 99%

Lateral Femoral Cutaneous Nerve Decompression Guided by Preoperative Ultrasound Mapping

Ellis¹,

Schneider²,

Cloney³

et al. 2018

Cureus

View full text Add to dashboard Cite

Injury to the lateral femoral cutaneous nerve (LFCN) from compression or entrapment may result in meralgia paresthetica, a painful mononeuropathy of the anterolateral thigh. Surgical decompression of the LFCN may provide relief when conservative management fails. However, the considerable anatomic variability of this nerve may complicate surgical localization and thus prolong operative time. Herein, we report the use of preoperative high-resolution ultrasonography to map the LFCN in a patient with bilateral meralgia paresthetica. This simple, noninvasive imaging technique was seen to be effective at providing precise localization of the entrapped and, in this case, bilateral anatomically variant nerves. Preoperative high-resolution ultrasound mapping of the LCFN can be used to facilitate precise operative localization in the treatment of bilateral meralgia paresthetica. This is especially useful in the setting of suspected unusual nerve anatomy.

show abstract

“…The patient is placed in the supine position on a stretcher in the radiology suite for ultrasound-guided wire localization of the LFCN. 7 Clear adhesive skin tape is used to hold the patient’s rostrally mobilized abdominal fat pannus in place, allowing for more direct access to the nerve.…”

Section: Transcriptmentioning

confidence: 99%

Lateral femoral cutaneous nerve transposition

Greeneway

Page

Ammanuel

et al. 2023

Neurosurgical Focus: Video

Self Cite

View full text Add to dashboard Cite

Lateral femoral cutaneous neuropathy, also known as meralgia paresthetica, is a pathology commonly encountered by neurosurgeons. Symptoms include numbness, tingling, and burning pain over the anterolateral thigh due to impingement on the lateral femoral cutaneous nerve (LFCN). Surgical treatment has traditionally involved nerve release or neurectomy. LFCN transposition is a relatively new approach that can provide excellent symptomatic relief. In this video, the authors highlight key operative techniques to ensure easy identification, adequate decompression, and transposition of the nerve. Key steps include ultrasound-guided wire localization, superficial decompression, opening of the inguinal ligament, deep decompression, and medial transposition. The video can be found here: https://stream.cadmore.media/r10.3171/2022.10.FOCVID2289

show abstract

Preoperative Ultrasound-Guided Wire Localization of the Lateral Femoral Cutaneous Nerve

Cited by 19 publications

References 27 publications

Carbon-Assisted Minimally Invasive Transtubular Approach for Intercostal Nerve Schwannoma

Carbon-Assisted Minimally Invasive Transtubular Approach for Intercostal Nerve Schwannoma

Lateral Femoral Cutaneous Nerve Decompression Guided by Preoperative Ultrasound Mapping

Lateral femoral cutaneous nerve transposition

Contact Info

Product

Resources

About