Carai Andrea, Fenu Grazia, Sechi Elia, Crotti Francesco M, Montella Andrea
Department of Biomedical Sciences, University of Sassari, Sassari, Italy.
Clin Anat. 2009 Apr;22(3):365-70. doi: 10.1002/ca.20766.
The lateral femoral cutaneous nerve (LFCN) is a branch of the lumbar plexus and supplies the skin of the lateral thigh region. This entrapment-compressive syndrome is named meralgia paresthetica or Roth's meralgia and depends, on a vast majority of cases, on the entrapment of the nerve in proximity of the inguinal ligament. Surgical decompression of the nerve is an option when conservative treatments fail and is usually performed through a 3-cm infrainguinal skin incision. Available data on anatomical variations of the LFCN derive from extensive cadaver dissections and lack many features relevant to the surgeon. This study was conducted to investigate anatomical details of the LFCN at the site of surgery for meralgia paresthetica. We reviewed retrospective data regarding the anatomical features of LFCN from 148 consecutive patients operated on for Roth's meralgia. In the majority of the cases the LFCN was a single trunk, deep to the thigh superficial fascia and to the inguinal ligament and coursing inferior-lateral to the anterior superior iliac spine. Less frequent findings were early nerve bifurcation, epifascial position, inferior-medial direction, and exit from the pelvis through an iliac bone canal. In 13 cases (8.8%) the nerve was not found at surgery. Anatomical variations of the LFCN must be considered at the time of surgery to maximize success rates and avoid nerve damage during surgical dissection.
股外侧皮神经（LFCN）是腰丛的一个分支，支配大腿外侧区域的皮肤。这种卡压性综合征被称为感觉异常性股痛或罗斯氏股痛，在绝大多数情况下，取决于神经在腹股沟韧带附近的卡压。当保守治疗失败时，神经减压手术是一种选择，通常通过腹股沟下3厘米的皮肤切口进行。关于LFCN解剖变异的现有数据来自广泛的尸体解剖，缺乏许多与外科医生相关的特征。本研究旨在调查感觉异常性股痛手术部位LFCN的解剖细节。我们回顾了148例因罗斯氏股痛接受手术的患者关于LFCN解剖特征的回顾性数据。在大多数病例中，LFCN为单干，位于大腿浅筋膜和腹股沟韧带深层，沿髂前上棘的下外侧走行。较少见的情况是神经早期分叉、筋膜上位置、下内侧方向以及通过髂骨管从骨盆穿出。在13例（8.8%）手术中未发现该神经。手术时必须考虑LFCN的解剖变异，以提高成功率并避免手术解剖过程中的神经损伤。
