Clinical Efficacy of Pulsed Radiofrequency Neuromodulation for Intractable Meralgia Paresthetica

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SCIENCE
Clinical Efficacy of Pulsed Radiofrequency Neuromodulation for Intractable Meralgia Paresthetica
Key Take-Away: 

The meralgia paresthetica patients who are refractory to conservative medical management or unfit to undergo surgery, the pulsed radiofrequency of the lateral femoral cutaneous nerve (LFCN) may offer a beneficial and low risk treatment. An absolute and sustained cessation of pain was achieved by a single treatment with pulsed radiofrequency.

Meralgia paresthetica (MP) is a neurologic disorder of the lateral femoral cutaneous nerve (LFCN), which is characterized by a localized area of paresthesia and numbness on the anterolateral aspect of the thigh.

ABSTRACT: 
Background: 

Meralgia paresthetica (MP) is a neurologic disorder of the lateral femoral cutaneous nerve (LFCN), which is characterized by a localized area of paresthesia and numbness on the anterolateral aspect of the thigh.

In most patients with MP, symptoms can be successfully managed with conservative treatment. However, in a small group of MP patients who are refractory to medical treatment, more aggressive low-risk treatment should be considered. The objective of this study was to evaluate clinical outcomes of pulsed radiofrequency (PRF) neuromodulation of the LFCN in MP patients refractory to conservative treatment.

Methods: 

Retrospective evaluation. We retrospectively reviewed the clinical data of 11 patients with medically intractable MP who underwent PRF neuromodulation of the LFCN.

These patients with MP underwent a diagnostic LFCN block using 2.0% lidocaine. Temporary pain relief > 50% was considered to be a positive response to the diagnostic nerve block. Following a positive response to the diagnostic nerve block, patients underwent PRF neuromodulation at 42 degrees for 2 minutes. Patient pain was evaluated using a 10-cm visual analog scale (VAS). In MP patients who received PRF, we statistically evaluated VAS scores and the presence of any complications for 6 or more months after the procedure.

Results: 

The mean initial patient VAS score was 6.4 + or - 0.97 cm. This score was decreased to 0.91 + or - 0.70 cm, 0.82 + or - 0.75 cm, and 0.63+ or - 0.90 cm at the one-, 3-, and 6- month follow-ups, respectively (P < 0.001).

Sixty-three point six percent of patients achieved complete pain relief (pain-free) in the last follow-up, whereas 27.3% of patients achieved successful pain relief (= 50% reduction in pain as determined by the VAS score). Furthermore, we did not observe any complications after the procedure.

Conclusion: 

PRF neuromodulation of the LFCN provides immediate and long-lasting pain relief without complications.

Therefore, PRF of the LCFN can be used as an alternative treatment in patients with MP who are refractory to conservative medical treatment.

Pain Physician 2016 Mar;19(3):173-9

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