Outcome after surgery for meralgia paresthetica - a retrospective cohort study

Area of Science:

• Neurology
• Surgical Research
• Pain Management

Background:

• Meralgia paresthetica causes chronic pain and sensory disturbances.
• Surgical interventions like neurolysis or neurectomy are considered when conservative treatments fail.
• Evidence supporting surgical outcomes for meralgia paresthetica remains limited.

Purpose of the Study:

• To evaluate the effectiveness of surgical treatments for meralgia paresthetica.
• To assess pain relief, sensory outcomes, and the durability of surgical results.
• To compare outcomes between different surgical procedures for meralgia paresthetica.

Main Methods:

• A single-center retrospective cohort study included patients surgically treated for meralgia paresthetica from 2019 to 2024.
• Outcomes including pain (NRS), sensory disturbances, and secondary surgery were analyzed.
• Statistical analyses included Wilcoxon signed-rank tests, Mann-Whitney U tests, and Kaplan-Meier analysis for reoperation rates.

Main Results:

• 101 patients underwent 128 procedures, with primary neurolysis (n=102) showing a median pain reduction of 6.5 NRS points (p < 0.001).
• Secondary neurectomy (n=18) resulted in a similar pain reduction of 7.0 points (p < 0.001), with no significant difference between procedures.
• 85.4% of patients remained free from reoperation at one year, and 64% experienced sensory improvement.

Conclusions:

• Surgical treatment for meralgia paresthetica provides substantial and durable pain relief.
• Neurolysis is an effective first-line surgical option with uncommon reoperations.
• Neurectomy offers comparable pain relief but is associated with unavoidable sensory loss.