Journal of Korean Neurosurgical Society

  • 제51권6호
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  • Pages.363-366
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  • 2012
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  • 2005-3711(pISSN)
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  • 1598-7876(eISSN)
대한신경외과학회 (The Korean Neurosurgical Society)
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Neurolysis for Megalgia Paresthetica

  • Son, Byung-Chul (Department of Neurosurgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Kim, Deok-Ryeong (Department of Neurosurgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Kim, Il-Sup (Department of Neurosurgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Hong, Jae-Taek (Department of Neurosurgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Sung, Jae-Hoon (Department of Neurosurgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Lee, Sang-Won (Department of Neurosurgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea)
  • 투고 : 2011.08.30
  • 심사 : 2012.06.13
  • 발행 : 2012.06.28
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초록

Objective : Meralgia paresthetica (MP) is a syndrome of pain and/or dysesthesia in the anterolateral thigh that is caused by an entrapment of the lateral femoral cutaneous nerve (LFCN) at its pelvic exit. Despite early accounts of MP, there is still no consensus concerning the effectiveness of neurolysis or transaction treatments in the long-term relief for medically refractory patients with MP. We retrospectively analyzed available long-term results of LFCN neurolysis for medically refractory MP in an effort to clarify this issue. Methods : During the last 7 years, 11 patients who had neurolysis for MP were enrolled in this study. Nerve entrapment was confirmed preoperatively by electrophysiological studies or a positive response to local anesthetic injection. Decompression of the LFCN was performed at the level of the iliac fascia, inguinal ligament, and fascia of the thigh distally. The outcome of surgery was assessed 8 weeks after the procedure followed at regular intervals if symptoms persisted. Results : Twelve decompression procedures were performed in 11 patients over a 7-year period. The average duration of symptoms was 8.5 months (range, 4-15 months). The average follow-up period was 33 months (range, 12-60 months). Complete and partial symptom improvement were noted in nine (81.8%) and two (18.2%) cases, respectively. No recurrence was reported. Conclusion : Neurolysis of the LFCN can provide adequate pain relief with minimal complications for medically refractory MP. To achieve a good outcome in neurolysis for MP, an accurate diagnosis with careful examination and repeated blocks of the LFCN, along with electrodiagnosis seems to be essential. Possible variation in the course of the LFCN and thorough decompression along the course of the LFCN should be kept in mind in planning decompression surgery for MP.

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참고문헌

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  6. Surgical options for meralgia paresthetica: long-term outcomes in 13 cases vol.33, pp.2, 2019, https://doi.org/10.1080/02688697.2018.1538480
  7. Dynamic decompression of the lateral femoral cutaneous nerve to treat meralgia paresthetica: technique and results vol.131, pp.5, 2019, https://doi.org/10.3171/2018.9.jns182004
  8. Dynamic decompression of the lateral femoral cutaneous nerve to treat meralgia paresthetica: technique and results vol.131, pp.5, 2019, https://doi.org/10.3171/2018.9.jns182004
  9. Fine architecture of the fascial planes around the lateral femoral cutaneous nerve at its pelvic exit: an epoxy sheet plastination and confocal microscopy study vol.131, pp.6, 2019, https://doi.org/10.3171/2018.7.jns181596
  10. Fine architecture of the fascial planes around the lateral femoral cutaneous nerve at its pelvic exit: an epoxy sheet plastination and confocal microscopy study vol.131, pp.6, 2019, https://doi.org/10.3171/2018.7.jns181596
  11. Meralgia paresthetica: finding an effective cure vol.132, pp.1, 2012, https://doi.org/10.1080/00325481.2019.1673582
  12. Patología periarticular de la cadera vol.54, pp.2, 2012, https://doi.org/10.1016/s1286-935x(21)45249-4