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Pulsed Radiofrequency Neuromodulation Treatment on the Lateral Femoral Cutaneous Nerve for the Treatment of Meralgia Paresthetica

  • Choi, Hyuk-Jai (Department of Neurosurgery, School of Medicine, Kyung Hee University) ;
  • Choi, Seok-Keun (Department of Neurosurgery, School of Medicine, Kyung Hee University) ;
  • Kim, Tae-Sung (Department of Neurosurgery, School of Medicine, Kyung Hee University) ;
  • Lim, Young-Jin (Department of Neurosurgery, School of Medicine, Kyung Hee University)
  • Received : 2011.02.28
  • Accepted : 2011.08.16
  • Published : 2011.08.28

Abstract

We describe a rare case of pulsed radiofrequency treatment for pain relief associated with meralgia paresthetica. A 58-year-old female presented with pain in the left anterior lateral thigh. An imaging study revealed no acute lesions compared with a previous imaging study, and diagnosis of meralgia paresthetica was made. She received temporary pain relief with lateral femoral cutaneous nerve blocks twice. We performed pulsed radiofrequency treatment, and the pain declined to 25% of the maximal pain intensity. At 4 months after the procedure, the pain intensity did not aggravate without medication. Pulsed radiofrequency neuromodulation treatment on the lateral femoral cutaneous nerve may offer an effective, low risk treatment in patients with meralgia paresthetica who are refractory to conservative medical treatment.

Keywords

References

  1. Barna SA, Hu MM, Buxo C, Trella J, Cosgrove GR : Spinal cord stimulation for treatment of meralgia paresthetica. Pain Physician 8 : 315-318, 2005
  2. Cahana A, Vutskits L, Muller D : Acute differential modulation of synaptic transmission and cell survival during exposure to pulsed and continuous radiofrequency energy. J Pain 4 : 197-202, 2003 https://doi.org/10.1016/S1526-5900(03)00554-6
  3. Cosman ER Jr, Cosman ER Sr : Electric and thermal field effects in tissue around radiofrequency electrodes. Pain Med 6 : 405-424, 2005 https://doi.org/10.1111/j.1526-4637.2005.00076.x
  4. de Ridder VA, de Lange S, Popta JV : Anatomical variations of the lateral femoral cutaneous nerve and the consequences for surgery. J Orthop Trauma 13 : 207-211, 1999 https://doi.org/10.1097/00005131-199903000-00009
  5. Dias Filho LC, Valença MM, Guimarães Filho FA, Medeiros RC, Silva RA, Morais MG, et al. : Lateral femoral cutaneous neuralgia : an anatomical insight. Clin Anat 16 : 309-316, 2003 https://doi.org/10.1002/ca.10106
  6. Friedlander WJ : Meralgia paresthetica. U S Armed Forces Med J 3 : 1857-1862, 1952
  7. Higuchi Y, Nashold BS Jr, Sluijter M, Cosman E, Pearlstein RD : Exposure of the dorsal root ganglion in rats to pulsed radiofrequency currents activates dorsal horn lamina I and II neurons. Neurosurgery 50 : 850-855; discussion 856, 2002 https://doi.org/10.1097/00006123-200204000-00030
  8. Khalil N, Nicotra A, Rakowicz W : Treatment for meralgia paraesthetica. Cochrane Database Syst Rev : CD004159, 2008
  9. Kosiyatrakul A, Nuansalee N, Luenam S, Koonchornboon T, Prachaporn S : The anatomical variation of the lateral femoral cutaneous nerve in relation to the anterior superior iliac spine and the iliac crest. Musculoskelet Surg 94 : 17-20
  10. Munglani R : The longer term effect of pulsed radiofrequency for neuropathic pain. Pain 80 : 437-439, 1999 https://doi.org/10.1016/S0304-3959(98)00183-3
  11. Nouraei SA, Anand B, Spink G, O'Neill KS : A novel approach to the diagnosis and management of meralgia paresthetica. Neurosurgery 60 : 696-700; discussion 700, 2007 https://doi.org/10.1227/01.NEU.0000255392.69914.F7
  12. Philip CN, Candido KD, Joseph NJ, Crystal GJ : Successful treatment of meralgia paresthetica with pulsed radiofrequency of the lateral femoral cutaneous nerve. Pain Physician 12 : 881-885, 2009
  13. Ray B, D'Souza AS, Kumar B, Marx C, Ghosh B, Gupta NK, et al. : Variations in the course and microanatomical study of the lateral femoral cutaneous nerve and its clinical importance. Clin Anat 23 : 978-984, 2010 https://doi.org/10.1002/ca.21043
  14. Rohof OJ : Radiofrequency treatment of peripheral nerves. Pain Pract 2 : 257-260, 2002 https://doi.org/10.1046/j.1533-2500.2002.02033.x
  15. Seror P, Seror R : Meralgia paresthetica : clinical and electrophysiological diagnosis in 120 cases. Muscle Nerve 33 : 650-654, 2006 https://doi.org/10.1002/mus.20507
  16. Son JH, Kim SD, Kim SH, Lim DJ, Park JY : The efficacy of repeated radiofrequency medial branch neurotomy for lumbar facet syndrome. J Korean Neurosurg Soc 48 : 240-243, 2010 https://doi.org/10.3340/jkns.2010.48.3.240

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