Intraoperative Decision Making for Neurolysis versus Neurectomy in Surgical Treatment of Meralgia Paresthetica

Aim: To evaluate the intraoperative decision for neurolysis or neurectomy in management of meralgia paresthetica.Methods: Diagnosis of Meralgia paresthetica is usually based on clinical examination and is supported by sensory nerve conduction (SNC) studies. The initial treatment is always conservative. In limited number of patients who are refractory to conservative managements, surgical treatment via decompression/neurolysis or neurectomy is concerned.Methods: A retrospective study conducted on 40 patients from a cluster sample from patients with meralgia paresthetica who operated through neurolysis or neurectomy between January 2017 to March 2022 at the neurosurgical departments, Menoufia University, Egypt.Results: completely pain and numbness were significantly improved after neurectomy (Group I) by 16 cases (80%) and 15 cases (75%) than after neurolysis (Group II) by 6 cases (30%) and 3 cases (15%), respectively. While partial pain and numbness were significantly decreased among Group I by 4 cases (20%) and 5 cases (25%) than Group II by 14 cases (70%) and 17 cases (85%), respectively with p value <0.001.Conclusion: Results of our study show that chances for pain relief in adult patients with meralgia paresthetica are higher after the neurectomy than after the neurolysis procedure, and that most patients are not bothered by the numbness following the neurectomy procedure.