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Vulnerability of the femoral nerve during complex anterior and posterior spinal surgery
Swetha Naroji1, Laurence J Belin, Mitchell Gil Maltenfort
1Department of Neurosurgery, Jefferson Medical College, Philadelphia, Pennsylvania 19107, USA.
Background:
Femoral nerve palsy is not a common adverse effect of lumbar spinal surgery.
Objective:
To report 3 unique cases of femoral nerve neuropathy due to instrumentation and positioning during complex anterior and posterior spinal surgery.
Methods:
Case series
Results:
All 3 patients demonstrated femoral nerve neuropathy. The first patient presented postoperatively but after 6 months, the palsy resolved. Femoral nerve malfunctioning was documented in the second and third patients intraoperatively; however, with rapid patient repositioning and removal of offending instrumentation, postoperative palsy was avoided.
Conclusions:
Use of motor evoked potential monitoring of the femoral nerve during surgery is vital for the prevention of future neuropathies, an avoidable complication of spinal surgery.
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