Outcomes of lateral femoral cutaneous nerve decompression surgery in meralgia paraesthetica: assessment of pain, sensory deficits, and quality of life.

Abstract

Purpose: Meralgia paraesthetica (MP) is a rare neuropathy of the lateral femoral cutaneous nerve (LFCN), characterized by thigh pain, paraesthesia, or sensory loss. When conservative treatments fail, surgical interventions such as neurolysis or neurectomy are considered. This study aims to evaluate the effectiveness of surgical decompression of the LFCN in alleviating pain, addressing sensory deficits, and improving quality of life.

Methods: A prospective study was conducted on 26 patients who underwent LFCN decompression surgery between 2015 and 2023, with a minimum follow-up period of one year. Outcomes were assessed using pre- and postoperative questionnaires, including the Brief Pain Inventory (BPI) and the Pain Disability Index (PDI).

Results: The cohort consisted of 15 males and 11 females, with 81% reporting symptom onset following prior surgeries or trauma. Postoperatively, 95.8% of patients experienced pain relief, with 76.9% achieving complete pain resolution (NRS 0). There was a significant reduction in average perceived pain (from 6.6 ± 1.9 to 0.7 ± 1.1; p < 0.001) and maximum perceived pain (8.0 ± 1.54 to 1.0 ± 1.67; p < 0.001). Full sensory function was restored in 61.2% of patients, and quality of life scores improved markedly, with an average increase of 8.4 out of 10 points (± 1.9; p < 0.001).

Conclusion: These results demonstrate that neurolysis of the LFCN is highly effective in the treatment of refractory MP, offering substantial pain relief, sensory restoration, and improved quality of life. Furthermore, patients with previous injuries or surgeries benefited most from NL, suggesting that these factors serve as positive prognostic indicators.