Injuries to the lateral femoral cutaneous nerve during spine surgery
A prospective study to locate patients with injured lateral femoral cutaneous nerve after elective spine surgery. To assess the prevalence of injury of the lateral femoral cutaneous nerve and to identify the cause of injury according to the position of the patients at surgery and the surgical approa...
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| Veröffentlicht in: | Spine (Philadelphia, Pa. 1976) Pa. 1976), 2000-05, Vol.25 (10), p.1266-1269 |
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| creator | Mirovsky, Y Neuwirth, M |
| description | A prospective study to locate patients with injured lateral femoral cutaneous nerve after elective spine surgery.
To assess the prevalence of injury of the lateral femoral cutaneous nerve and to identify the cause of injury according to the position of the patients at surgery and the surgical approach.
Injuries to the lateral femoral cutaneous nerve, also known as meralgia paresthetica, may cause pain and therefore result in restriction of activity. Compression of the nerve by disc hernia, retroperitoneal tumors, and external pressure around the anterior superior iliac spine are among the more common causes.
One hundred five patients admitted for elective spine procedures were grouped according to position on the operating table and surgical approach. All patients were examined before and after surgery for signs of injury to the lateral femoral cutaneous nerve, and those found injured were followed up for 1 year after surgery.
Injury to the lateral femoral cutaneous nerve was found in 21 (20%) patients. In 6 of them, all of whom underwent surgery on the Hall-Relton frame, the injury was bilateral. In 7 patients the injury was not associated with discomfort. In addition to injury by external pressure at the anterior superior iliac spine from the Hall-Relton frame, the nerve was also injured at the retroperitoneum by hematoma or traction and at the anterior iliac crest when bone was harvested. In 89% of the patients, the nerve completely recovered within 3 months of surgery. Two patients still had pain 1 year after surgery and hypoesthesia of the anterolateral thigh.
Injuries to the lateral femoral cutaneous nerve during spine surgery are frequent, and patients should be informed of the possible risk. It usually has a benign course, but some preventive steps should be taken: keep posterior to the anterior superior iliac spine and minimize retraction when harvesting a bone graft, pad the posts of the Hall-Relton frame over the anterior superior iliac crest, and avoid traction on the psoas muscle during the retroperitoneal dissection. |
| doi_str_mv | 10.1097/00007632-200005150-00011 |
| format | Article |
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To assess the prevalence of injury of the lateral femoral cutaneous nerve and to identify the cause of injury according to the position of the patients at surgery and the surgical approach.
Injuries to the lateral femoral cutaneous nerve, also known as meralgia paresthetica, may cause pain and therefore result in restriction of activity. Compression of the nerve by disc hernia, retroperitoneal tumors, and external pressure around the anterior superior iliac spine are among the more common causes.
One hundred five patients admitted for elective spine procedures were grouped according to position on the operating table and surgical approach. All patients were examined before and after surgery for signs of injury to the lateral femoral cutaneous nerve, and those found injured were followed up for 1 year after surgery.
Injury to the lateral femoral cutaneous nerve was found in 21 (20%) patients. In 6 of them, all of whom underwent surgery on the Hall-Relton frame, the injury was bilateral. In 7 patients the injury was not associated with discomfort. In addition to injury by external pressure at the anterior superior iliac spine from the Hall-Relton frame, the nerve was also injured at the retroperitoneum by hematoma or traction and at the anterior iliac crest when bone was harvested. In 89% of the patients, the nerve completely recovered within 3 months of surgery. Two patients still had pain 1 year after surgery and hypoesthesia of the anterolateral thigh.
Injuries to the lateral femoral cutaneous nerve during spine surgery are frequent, and patients should be informed of the possible risk. It usually has a benign course, but some preventive steps should be taken: keep posterior to the anterior superior iliac spine and minimize retraction when harvesting a bone graft, pad the posts of the Hall-Relton frame over the anterior superior iliac crest, and avoid traction on the psoas muscle during the retroperitoneal dissection.</description><identifier>ISSN: 0362-2436</identifier><identifier>DOI: 10.1097/00007632-200005150-00011</identifier><identifier>PMID: 10806504</identifier><language>eng</language><publisher>United States</publisher><subject>Age Distribution ; Female ; Humans ; Ilium - surgery ; Intraoperative Complications - epidemiology ; Lumbosacral Plexus - anatomy & histology ; Lumbosacral Plexus - injuries ; Male ; Nerve Compression Syndromes - epidemiology ; Neuralgia - epidemiology ; Peripheral Nerve Injuries ; Peripheral Nerves - anatomy & histology ; Prevalence ; Prospective Studies ; Psoas Muscles ; Sex Distribution ; Spinal Diseases - surgery ; Surgical Instruments ; Surgical Procedures, Operative - adverse effects ; Treatment Outcome</subject><ispartof>Spine (Philadelphia, Pa. 1976), 2000-05, Vol.25 (10), p.1266-1269</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c340t-809d2671125f96b3e49bd9a0027b773be82709828397faaba14ac39a7bb188b43</citedby><cites>FETCH-LOGICAL-c340t-809d2671125f96b3e49bd9a0027b773be82709828397faaba14ac39a7bb188b43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10806504$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mirovsky, Y</creatorcontrib><creatorcontrib>Neuwirth, M</creatorcontrib><title>Injuries to the lateral femoral cutaneous nerve during spine surgery</title><title>Spine (Philadelphia, Pa. 1976)</title><addtitle>Spine (Phila Pa 1976)</addtitle><description>A prospective study to locate patients with injured lateral femoral cutaneous nerve after elective spine surgery.
To assess the prevalence of injury of the lateral femoral cutaneous nerve and to identify the cause of injury according to the position of the patients at surgery and the surgical approach.
Injuries to the lateral femoral cutaneous nerve, also known as meralgia paresthetica, may cause pain and therefore result in restriction of activity. Compression of the nerve by disc hernia, retroperitoneal tumors, and external pressure around the anterior superior iliac spine are among the more common causes.
One hundred five patients admitted for elective spine procedures were grouped according to position on the operating table and surgical approach. All patients were examined before and after surgery for signs of injury to the lateral femoral cutaneous nerve, and those found injured were followed up for 1 year after surgery.
Injury to the lateral femoral cutaneous nerve was found in 21 (20%) patients. In 6 of them, all of whom underwent surgery on the Hall-Relton frame, the injury was bilateral. In 7 patients the injury was not associated with discomfort. In addition to injury by external pressure at the anterior superior iliac spine from the Hall-Relton frame, the nerve was also injured at the retroperitoneum by hematoma or traction and at the anterior iliac crest when bone was harvested. In 89% of the patients, the nerve completely recovered within 3 months of surgery. Two patients still had pain 1 year after surgery and hypoesthesia of the anterolateral thigh.
Injuries to the lateral femoral cutaneous nerve during spine surgery are frequent, and patients should be informed of the possible risk. It usually has a benign course, but some preventive steps should be taken: keep posterior to the anterior superior iliac spine and minimize retraction when harvesting a bone graft, pad the posts of the Hall-Relton frame over the anterior superior iliac crest, and avoid traction on the psoas muscle during the retroperitoneal dissection.</description><subject>Age Distribution</subject><subject>Female</subject><subject>Humans</subject><subject>Ilium - surgery</subject><subject>Intraoperative Complications - epidemiology</subject><subject>Lumbosacral Plexus - anatomy & histology</subject><subject>Lumbosacral Plexus - injuries</subject><subject>Male</subject><subject>Nerve Compression Syndromes - epidemiology</subject><subject>Neuralgia - epidemiology</subject><subject>Peripheral Nerve Injuries</subject><subject>Peripheral Nerves - anatomy & histology</subject><subject>Prevalence</subject><subject>Prospective Studies</subject><subject>Psoas Muscles</subject><subject>Sex Distribution</subject><subject>Spinal Diseases - surgery</subject><subject>Surgical Instruments</subject><subject>Surgical Procedures, Operative - adverse effects</subject><subject>Treatment Outcome</subject><issn>0362-2436</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2000</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpNkMtOwzAQRb0A0VL4BeQVu8A4TvxYogKlUiU2sLbsZFJS5VHsBKl_j0sKYjZ3dHXnoUMIZXDHQMt7iCUFT5P02OUshyQqY2dkDlxEO-NiRi5D2EVbcKYvyIyBApFDNieP6243-hoDHXo6fCBt7IDeNrTCtj9qMQ62w34MtEP_hbSM6W5Lw77ukIbRb9Efrsh5ZZuA1yddkPfnp7flS7J5Xa2XD5uk4BkMiQJdpkIyluaVFo5jpl2pLUAqnZTcoUolaJUqrmVlrbMsswXXVjrHlHIZX5Dbae_e958jhsG0dSiwaaYPTVzNYhJiUE3BwvcheKzM3tet9QfDwBypmV9q5o-a-aEWR29ON0bXYvlvcELGvwHujGk-</recordid><startdate>20000515</startdate><enddate>20000515</enddate><creator>Mirovsky, Y</creator><creator>Neuwirth, M</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20000515</creationdate><title>Injuries to the lateral femoral cutaneous nerve during spine surgery</title><author>Mirovsky, Y ; Neuwirth, M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c340t-809d2671125f96b3e49bd9a0027b773be82709828397faaba14ac39a7bb188b43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2000</creationdate><topic>Age Distribution</topic><topic>Female</topic><topic>Humans</topic><topic>Ilium - surgery</topic><topic>Intraoperative Complications - epidemiology</topic><topic>Lumbosacral Plexus - anatomy & histology</topic><topic>Lumbosacral Plexus - injuries</topic><topic>Male</topic><topic>Nerve Compression Syndromes - epidemiology</topic><topic>Neuralgia - epidemiology</topic><topic>Peripheral Nerve Injuries</topic><topic>Peripheral Nerves - anatomy & histology</topic><topic>Prevalence</topic><topic>Prospective Studies</topic><topic>Psoas Muscles</topic><topic>Sex Distribution</topic><topic>Spinal Diseases - surgery</topic><topic>Surgical Instruments</topic><topic>Surgical Procedures, Operative - adverse effects</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mirovsky, Y</creatorcontrib><creatorcontrib>Neuwirth, M</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Spine (Philadelphia, Pa. 1976)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mirovsky, Y</au><au>Neuwirth, M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Injuries to the lateral femoral cutaneous nerve during spine surgery</atitle><jtitle>Spine (Philadelphia, Pa. 1976)</jtitle><addtitle>Spine (Phila Pa 1976)</addtitle><date>2000-05-15</date><risdate>2000</risdate><volume>25</volume><issue>10</issue><spage>1266</spage><epage>1269</epage><pages>1266-1269</pages><issn>0362-2436</issn><abstract>A prospective study to locate patients with injured lateral femoral cutaneous nerve after elective spine surgery.
To assess the prevalence of injury of the lateral femoral cutaneous nerve and to identify the cause of injury according to the position of the patients at surgery and the surgical approach.
Injuries to the lateral femoral cutaneous nerve, also known as meralgia paresthetica, may cause pain and therefore result in restriction of activity. Compression of the nerve by disc hernia, retroperitoneal tumors, and external pressure around the anterior superior iliac spine are among the more common causes.
One hundred five patients admitted for elective spine procedures were grouped according to position on the operating table and surgical approach. All patients were examined before and after surgery for signs of injury to the lateral femoral cutaneous nerve, and those found injured were followed up for 1 year after surgery.
Injury to the lateral femoral cutaneous nerve was found in 21 (20%) patients. In 6 of them, all of whom underwent surgery on the Hall-Relton frame, the injury was bilateral. In 7 patients the injury was not associated with discomfort. In addition to injury by external pressure at the anterior superior iliac spine from the Hall-Relton frame, the nerve was also injured at the retroperitoneum by hematoma or traction and at the anterior iliac crest when bone was harvested. In 89% of the patients, the nerve completely recovered within 3 months of surgery. Two patients still had pain 1 year after surgery and hypoesthesia of the anterolateral thigh.
Injuries to the lateral femoral cutaneous nerve during spine surgery are frequent, and patients should be informed of the possible risk. It usually has a benign course, but some preventive steps should be taken: keep posterior to the anterior superior iliac spine and minimize retraction when harvesting a bone graft, pad the posts of the Hall-Relton frame over the anterior superior iliac crest, and avoid traction on the psoas muscle during the retroperitoneal dissection.</abstract><cop>United States</cop><pmid>10806504</pmid><doi>10.1097/00007632-200005150-00011</doi><tpages>4</tpages></addata></record> |
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| ispartof | Spine (Philadelphia, Pa. 1976), 2000-05, Vol.25 (10), p.1266-1269 |
| issn | 0362-2436 |
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| source | MEDLINE; Journals@Ovid Complete |
| subjects | Age Distribution Female Humans Ilium - surgery Intraoperative Complications - epidemiology Lumbosacral Plexus - anatomy & histology Lumbosacral Plexus - injuries Male Nerve Compression Syndromes - epidemiology Neuralgia - epidemiology Peripheral Nerve Injuries Peripheral Nerves - anatomy & histology Prevalence Prospective Studies Psoas Muscles Sex Distribution Spinal Diseases - surgery Surgical Instruments Surgical Procedures, Operative - adverse effects Treatment Outcome |
| title | Injuries to the lateral femoral cutaneous nerve during spine surgery |
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