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Decision making in the surgical treatment of meralgia paresthetica: neurolysis versus neurectomy

Abstract

Background

Surgical treatment options for meralgia paresthetica include neurolysis and neurectomy procedures. Reported success rates for pain relief are generally higher after neurectomy, but an obvious disadvantage compared with neurolysis is the loss of sensation in the anterolateral part of the thigh. In this study we analyzed our results on pain relief after both procedures, and we determined the impact of loss of sensation with a questionnaire.

Methods

Between 1999 and 2009, all patients with persistent symptoms of meralgia paresthetica who presented to our clinic after failure of conservative treatment were offered a neurectomy procedure. After this period, the surgical strategy was changed to first neurolysis followed by neurectomy in case of failure. We retrospectively analyzed our results for both strategies with a questionnaire that was focused on pain relief, numbness and the impact of numbness.

Results

Ten patients underwent a neurolysis with a 60 % pain relief rate compared to 87.5 % of the eight patients that primarily underwent a neurectomy. Most neurectomy patients (62.5 %) were not hindered by the numbness, 25 % sometimes and only one patient was frequently bothered, but was still satisfied with the outcome. The failures of neurolysis were secondarily treated by neurectomy, which resulted in pain relief in three out of four patients.

Conclusions

This series confirms previous reports in the literature that have shown higher success rates for the neurectomy procedure. In addition, it shows that most patients are not bothered by the numbness following this procedure. These observations can be used in the surgical decision making for meralgia paresthetica.

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Acknowledgments

The authors thank the secretaries Sandra Annokkee and Jannie van Duijn for their help in gathering the medical records and sending out the questionnaires.

Conflicts of interest

None.

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Corresponding author

Correspondence to Alfred Kloet.

Appendix

Appendix

English translation of the follow-up questionnaire (adapted from [1]):

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de Ruiter, G.C.W., Wurzer, J.A.L. & Kloet, A. Decision making in the surgical treatment of meralgia paresthetica: neurolysis versus neurectomy. Acta Neurochir 154, 1765–1772 (2012). https://doi.org/10.1007/s00701-012-1431-0

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Keywords

  • Meralgia paresthetica
  • Neurolysis
  • Decompression
  • Neurectomy
  • Neurexeresis