OBJECTIVEThe results of lateral femoral cutaneous nerve (LFCN)
decompression to treat idiopathic
meralgia paresthetica (
iMP) vary widely. Techniques to decompress the LFCN differ, which may affect outcome, but in MP it is unknown to what extent. The authors present a new technique using dynamic
decompression and discuss the outcomes.METHODSA retrospective cohort study was performed in a consecutive series of 19 cases. The goal of
decompression was
pain relief and recovery of sensation. The plane ventral to the LFCN was decompressed by cutting the fascia lata and the inferior aspect of the inguinal ligament. The plane dorsal to the LFCN was decompressed by cutting the fascia of the sartorius muscle. Subsequently, the thigh was brought in full range of flexion and extension/abduction. The authors identified and additionally cut fibers that tightened and caused compression at various locations of the LFCN during movement in all patients, referring to this technique as dynamic
decompression. Postoperatively, an independent neurologist scored
pain and sensation on a 4-point scale: completely resolved, improved, not changed, or worsened. Patients scored their remaining
pain or sensory deficit as a percentage of the preoperative level. Statistical assessment was done using ANOVA to assess the association between outcome and duration of preoperative symptoms, BMI, and length of follow-up.RESULTSIn 17 of the 19 cases (89%), the
pain and/or
paresthesia completely resolved. Patients in the remaining 2 cases (11%) experienced 70% and 80% reduction in
pain. Sensation completely recovered in 13 of the 19 cases (69%). In 5 of the 19 cases (26%) sensation improved, but an area of
hypesthesia remained. Four of these 5 patients indicated a sensory improvement of more than 75%, and the remaining patient had 50% improvement. Sensation remained unchanged in 1 case (5%) with persisting
hypesthesia and mild
hyperesthesia. There was no significant impact of preoperative symptom duration, BMI, and length of follow-up on postoperative outcome.CONCLUSIONSDynamic
decompression of the LFCN is an effective technique for the treatment of
iMP. Most patients become completely
pain free and sensation recovers considerably.