Meralgia paresthetica (MP) is a rare lateral femoral cutaneous nerve-(LFCN)-
mononeuropathy. Treatment for this disorder includes conservative and operative approaches; the latter is considered if
conservative therapy fails. The most commonly used surgical approaches are
decompression/neurolysis and avulsion/
neurectomy. However, there are no definitive guidelines on the optimal surgical approach to be used. The purpose of this study was to evaluate the outcome of
surgical decompression of the LFCN for the treatment of persistent MP with preservation of sensation along the distribution of the LFCN.We evaluated the outcomes of LFCN procedures performed between 2015 and 2016. A total of 16
surgical decompressions could be identified. Retrospective analysis of prospectively collected patient data was performed, as well as systematic evaluation of the postoperative course, with regular follow-up examinations based on a standardized protocol.
Pain was analyzed using an NRS (numeric rating scale). Several postsurgical parameters, including temperature
hypersensitivity and
numbness in the LFCN region, were compared with the presurgical data.Sixty-nine percent of patients had histories of
trauma or surgery, which were designated as the onset of
pain. Of these patients, 78% had
hip prostheses, 2 had previous falls. Postoperatively, a significant reduction of 6.6 points in the mean NRS
pain value was observed. All other evaluated parameters also improved postoperatively. Patient satisfaction was high, with 86% reporting complete satisfaction, and 14% reporting partial satisfaction.Previous studies favor either avulsion/
neurectomy as the preferred procedure for MP treatment, or provide no recommendation. Our findings instead confirm the
decompression/neurolysis approach as the primary
surgical procedure of choice for the treatment of MP, if
conservative treatment fails.