scholarly journals Effect of Fascia Penetration in Lateral Femoral Cutaneous Nerve Conduction

2020 ◽  
Vol 44 (6) ◽  
pp. 459-467
Author(s):  
Mi-Jeong Yoon ◽  
Hye Min Park ◽  
Sun Jae Won
Keyword(s):  
Sensory Nerve ◽  
Conventional Technique ◽  
Cutaneous Nerve ◽  
Lateral Femoral Cutaneous Nerve ◽  
Femoral Cutaneous Nerve ◽  
Sensory Nerve Action ◽  
Kolmogorov Smirnov ◽  
A New Technique ◽  
Time Required ◽  
Stimulation Technique

Objective To evaluate the effect of fascia penetration and develop a new technique for lateral femoral cutaneous nerve (LFCN) conduction studies based on the fascia penetration point (PP) identified using ultrasound.Methods The fascia PP of the LFCN was localized in 20 healthy subjects, and sensory nerve action potentials (SNAPs) were obtained at four different stimulation points—2 cm proximal to the PP (2PPP), PP, 2 cm distal to the PP (2DPP), and 4 cm distal to the PP (4DPP). We compared the stimulation technique based on the fascia penetration point (STBFP) with the conventional technique.Results The SNAP amplitude of the LFCN was significantly higher when stimulation was performed at the PP and 2DPP than at other stimulation points. Using the STBFP, SNAP responses were elicited in 38 of 40 legs, whereas they were elicited in 32 of 40 legs using the conventional technique (p=0.041). STBFP had a comparable SNAP amplitude and slightly delayed negative peak latency compared to the conventional technique. In terms of the time required, the time spent on STBFP showed a more consistent distribution than the time spent on the conventional technique (two-sample Kolmogorov–Smirnov test, p<0.05).Conclusion SNAP of the LFCN significantly changed near the fascia PP, and stimulation at PP and at 2DPP provided high amplitudes. STBFP can help increase the response rate and ensure stable and consistent procedure time of the LFCN conduction study.

scholarly journals Ultrasound-Guided Diagnosis and Treatment of Meralgia Paresthetica

2016 ◽  
Vol 4;19 (4;5) ◽  
pp. E667-E669
Author(s):  
Ayse Merve Ata
Keyword(s):  
Sensory Nerve ◽  
Psoas Muscle ◽  
Cutaneous Nerve ◽  
Lateral Femoral Cutaneous Nerve ◽  
Inguinal Ligament ◽  
Leg Length ◽  
External Compression ◽  
Meralgia Paresthetica ◽  
Prolonged Standing ◽  
Femoral Cutaneous Nerve

Meralgia paresthetica refers to the entrapment of the lateral femoral cutaneous nerve at the level of the inguinal ligament. The lateral femoral cutaneous nerve – a purely sensory nerve – arises from the L2 and L3 spinal nerve roots, travels downward lateral to the psoas muscle, and then crosses the iliacus muscle. Close to the anterior superior iliac spine, the nerve courses in contact with the lateral aspect of the inguinal ligament and eventually innervates the lateral thigh. The entrapment syndrome is usually idiopathic but can also ensue due to trauma/ overuse, pelvic and retroperitoneal tumors, stretching of the nerve due to prolonged leg/trunk hyperextension, leg length discrepancies, prolonged standing, external compression by belts, weight gain, and tight clothing. The diagnosis of Meralgia paresthetica is usually clinical, i.e., based on the following symptoms: paresthesia, numbness, burning sensation, dysesthesia, and pain over the anterolateral aspects of the thigh. These complaints may be worsened by walking or prolonged standing and typically disappear after weight loss, abdominal muscle strengthening, or elimination of the underlying cause. Although there are several reports on the confirmatory role of electrodiagnostic studies in the diagnosis of Meralgia paresthetica, electromyographers would usually prefer/suggest not to perform nerve conduction studies in daily clinical practice. Herewith, due to its several advantages, ultrasound imaging has been proposed as an alternative diagnostic method in the recent literature. It not only confirms the entrapment morphologically, but also uncovers a likely underlying cause and provides immediate interventional guidance. The pertinent sonographic findings would be hypoechoic and swollen lateral femoral cutaneous nerve. Key words: Meralgia paresthetica, ultrasound, diagnosis, treatment

scholarly journals Decompression and Neurolysis of the Lateral Femoral Cutaneous Nerve in the Surgical Treatment of Meralgia Paresthetica and The Results

2020 ◽  
Author(s):  
Kenan Kıbıcı ◽  
Berrin Erok ◽  
Ali Önder Atca
Keyword(s):  
Surgical Treatment ◽  
Sensory Nerve ◽  
Cutaneous Nerve ◽  
Lateral Femoral Cutaneous Nerve ◽  
Meralgia Paresthetica ◽  
Number Of Patients ◽  
First Choice ◽  
Femoral Cutaneous Nerve ◽  
Nonobese Patients ◽  
Clinical Conditions

AbstractMeralgia paresthetica (MP), also known as Bernhardt–Roth syndrome, is a peripheral neuropathy of the primary sensory lateral femoral cutaneous nerve (LFCN). Its diagnosis is challenging, because it can mimic other clinical conditions particularly associated with upper lumbar spine or pelvis. Patients present with pain and paresthesia over the anterolateral thigh. Diagnosis is usually based on clinical examination and is supported by sensory nerve conduction (SNC) studies. The initial treatment is always conservative. In limited number of patients who are refractory to conservative managements, surgical treatment via decompression/neurolysis or neurectomy is concerned. There is still no consensus on which surgical technique is the best and the first choice. We retrospectively analyzed the surgical outcomes of 12 nonobese patients who underwent decompression/neurolysis between the years 2013 and 2018. Bilateral SNC studies were performed in all cases which supported the diagnosis. We applied conservative treatments for 3 months in addition to the treatments previously applied in other centers. Surgery was recommended for the patients who were refractory to these treatments. Preoperative and postoperative pain levels during follow-up visits were evaluated with visual analogue scale (VAS). A retrospective analysis was performed on preoperative and postoperative 6th month VAS scores. The mean preoperative VAS value was 8.75 ± 0.62 and the postoperative VAS value at the sixth month was 1.17 ± 0.72. A significant reduction in the pain was shown (p < 0.05). Our surgical results showed that decompression/neurolysis of the LFCN should be concerned as the primary surgical approach to avoid negative outcomes of resection surgeries.

Harvesting Split-thickness Skin Grafts with Lateral Femoral Cutaneous Nerve Block

2004 ◽  
Vol 66 (6) ◽  
pp. 612-614
Author(s):  
Yukiko TERAMOTO ◽  
Makoto ICHIMIYA ◽  
Yuko TAKITA ◽  
Yoshiaki YOSHIKAWA ◽  
Masahiko MUTO
Keyword(s):  
Nerve Block ◽  
Cutaneous Nerve ◽  
Lateral Femoral Cutaneous Nerve ◽  
Skin Grafts ◽  
Thickness Skin ◽  
Femoral Cutaneous Nerve

The lateral femoral cutaneous nerve canal

2017 ◽  
Vol 126 (3) ◽  
pp. 972-978 ◽  
Author(s):  
Amgad Hanna
Keyword(s):  
Iliac Crest ◽  
Intraoperative Imaging ◽  
Femoral Nerve ◽  
Anatomical Variations ◽  
Cutaneous Nerve ◽  
Lateral Femoral Cutaneous Nerve ◽  
Nerve Transection ◽  
Meralgia Paresthetica ◽  
Anterolateral Thigh ◽  
Femoral Cutaneous Nerve

OBJECTIVE Meralgia paresthetica causes dysesthesias and burning in the anterolateral thigh. Surgical treatment includes nerve transection or decompression. Finding the nerve in surgery is very challenging. The author conducted a cadaveric study to better understand the variations in the anatomy of the lateral femoral cutaneous nerve (LFCN). METHODS Twenty embalmed cadavers were used for this study. The author studied the LFCN's relationship to different fascial planes, and the distance from the anterior superior iliac spine (ASIS). RESULTS A complete fascial canal was found to surround the nerve completely in all specimens. The canal starts at the inguinal ligament proximally and follows the nerve beyond its terminal branches. The nerve could be anywhere from 6.5 cm medial to the ASIS to 6 cm lateral to the ASIS. In the latter case, the nerve may lodge in a groove in the iliac crest. Other anatomical variations found were the LFCN arising from the femoral nerve, and a duplicated nerve. A thick nerve was found in 1 case in which it was riding over the ASIS. CONCLUSIONS The variability in the course of the LFCN can create difficulty in surgical exposure. The newly defined LFCN canal renders exposure even more challenging. This calls for high-resolution pre- or intraoperative imaging for better localization of the nerve.

Anatomical Course of the Lateral Femoral Cutaneous Nerve and Its Susceptibility to Compression and Injury

1997 ◽  
Vol 100 (3) ◽  
pp. 600-604 ◽  
Author(s):  
Oskar C. Aszmann ◽  
Evan S. Dellon ◽  
A. Lee Dellon
Keyword(s):  
Cutaneous Nerve ◽  
Lateral Femoral Cutaneous Nerve ◽  
Femoral Cutaneous Nerve

Lateral Femoral Cutaneous Nerve of the Thigh

1990 ◽  
pp. 143-150 ◽  
Author(s):  
Oscar A. Turner ◽  
Norman Taslitz ◽  
Steven Ward
Keyword(s):  
Cutaneous Nerve ◽  
Lateral Femoral Cutaneous Nerve ◽  
Femoral Cutaneous Nerve

scholarly journals Blind Versus Ultrasound Guidance Injections: Lateral Femoral Cutaneous Nerve Blockage Revisited

2019 ◽  
Vol 25 (2) ◽  
pp. 54-57 ◽  
Author(s):  
Berke Aras ◽  
Emre Adıgüzel ◽  
Fatih Tok
Keyword(s):  
Ultrasound Guidance ◽  
Cutaneous Nerve ◽  
Lateral Femoral Cutaneous Nerve ◽  
Femoral Cutaneous Nerve

Anatomy of the lateral femoral cutaneous nerve related to inguinal ligament, adjacent bony landmarks, and femoral artery

2008 ◽  
Vol 21 (8) ◽  
pp. 769-774 ◽  
Author(s):  
Porames Doklamyai ◽  
Sithiporn Agthong ◽  
Vilai Chentanez ◽  
Thanasil Huanmanop ◽  
Chavarin Amarase ◽  
...  
Keyword(s):  
Femoral Artery ◽  
Cutaneous Nerve ◽  
Lateral Femoral Cutaneous Nerve ◽  
Inguinal Ligament ◽  
Bony Landmarks ◽  
Femoral Cutaneous Nerve
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