Symptom reduction and patient satisfaction after surgical therapy of Meralgia paresthetica – A bicentric retrospective analysis

Surgical treatment for Meralgia paresthetica is indicated in patients showing deficient effects of conservative interventions and merely temporary positive responses after local infiltrations of the lateral femoral cutaneous nerve (LFCN). To improve clinical outcome data, especially with focus on the long-term effect of such procedures, we evaluated patients in two neurosurgical centers with regard to their satisfaction and reduction of symptoms. Retrospective analysis of perioperative characteristics and follow-up telephone survey concerning subjective satisfaction after surgery using the Patient Satisfaction Index (PSI), subjective complaint reduction (percentage) and pain response (Numeric Rating Scale). In addition, health-related quality of life and sensation at the thigh were evaluated. Regression analysis concerning risk factors for an insufficient outcome was applied. A total of 108 surgeries were performed on 94 patients (50% female, median age 56 years, BMI 27.9 kg/m 2 ). 98 operations were neurolysis of the LFCN, 4 secondary neurectomies and 6 other revisions. A satisfying outcome at follow-up (PSI 1+2) was achieved at 84.4% of the patients, whereas 10.4% had no relevant symptom reduction (PSI 4). The average permanent complaint reduction was 72.7%. Concerning the residual pain intensity at the thigh at rest / under strain, 80.6% / 72.0% showed favorable values (NRS≤3). Regression analysis revealed nicotine abuse as independent risk factor for an unsatisfactorily outcome (OR 6.490; p=0.027) Surgical treatment of Meralgia paresthetica significantly improves associated complaints in the majority of patients leading to a high amount of satisfying results. Nicotine abuse seems to be a risk factor for insufficient outcomes. • 84.4% of surgically treated Meralgia paresthetica patients were satisfied. • The average permanent complaint reduction was 72.7%. • About 80% of the treated patients showed a residual NRS≤3 after surgery. • Only 10.4% had no relevant symptom reduction. • Nicotine abuse was an independent risk factor for an unsatisfactorily outcome.