Abstract
Aim: The aim of this study was to portray results of meralgia paresthetica (MP) treatment at our institution, as well as a review of current surgical treatment strategies. Methods: Diagnosis of MP was made based on a combination of typical patient symptoms, negative MRI of the lumbar spine, electrophysiological and ultrasound examinations of the lateral femoral cutaneous nerve (LFCN) and a diagnostic nerve block.
In cases where conservative therapy failed to improve the patient???s symptoms, surgical neurolysis of LFCN was performed. In cases of unsatisfactory relief of clinical symptoms, surgical neurotomy was off ered to the patient.
Results: Fifteen patients (13 males, 2 females) were surgically treated for MP from 2006 to 2020. Eleven cases were classified as idiopathic and four were classifi ed as iatrogenic.
In addition to typical pain, paresthesias and dysesthesias of the anterolateral thigh region, 13 patients presented also with hypesthesia of this region. Mean average preoperative Visual Analogue Pain Scale (VAS) was 8.4.
After undergoing surgical decompression, the average postoperative VAS after one year was 2.2. Three patients were unsatisfied after surgical neurolysis (VAS over 7), all of whom had an iatrogenic cause of MP.
Of these three patients, one opted for surgical neurotomy of the LFCN. Conclusion: Surgical neurolysis of the LFCN is an effective treatment for patients with MP in cases where conservative therapy fails.
Neurotomy although clearly effective, was reserved for cases of failed neurolysis, as it is accompanied with permanent hypesthesia of the anterolateral thigh.