Preoperative Ultrasound-Guided Localization of the Lateral Femoral Cutaneous Nerve: From Guide Wire to Novel Clip

Joyce Koueik; Jacob A Bethel; Kenneth S Lee; Michael J Tuite; Amgad S Hanna

doi:10.1227/ons.0000000000001072

Preoperative Ultrasound-Guided Localization of the Lateral Femoral Cutaneous Nerve: From Guide Wire to Novel Clip

Oper Neurosurg (Hagerstown). 2024 Jan 30. doi: 10.1227/ons.0000000000001072. Online ahead of print.

Authors

Joyce Koueik¹, Jacob A Bethel¹, Kenneth S Lee², Michael J Tuite², Amgad S Hanna¹

Affiliations

¹ Department of Neurological Surgery, University of Wisconsin, Madison, Wisconsin, USA.
² Department of Radiology, University of Wisconsin, Madison, Wisconsin, USA.

PMID: 38289069
DOI: 10.1227/ons.0000000000001072

Abstract

Background and objective: Lateral femoral cutaneous nerve (LFCN) decompression and transposition are surgical treatment options for meralgia paresthetica. Identifying the LFCN during surgery may be challenging, and preoperative localization is a valuable adjunct in this case. The objective of this study was to explore a new technique using preoperative ultrasound-guided clip localization (USCL) of the LFCN.

Methods: After Institutional Review Board approval, data were collected on patients who underwent both preoperative ultrasound-guided wire localization (USWL) and USCL over the past 13 years. Skin-to-nerve time was calculated prospectively.

Results: Fifty-six patients were identified, 51 had USWL and 5 had USCL; the skin-to-nerve median time was 7.5 and 6 minutes, respectively. Six wires were misplaced, and this was at the beginning of utilization of the USWL technique. There were no nerve injury, infection, or bleeding complications related to either wire or clip placement.

Conclusion: USWL or USCL is safe and time-efficient in LFCN surgeries.