Naroji Swetha, Belin Laurence J, Maltenfort Mitchell Gil, Vaccaro Alexander R, Schwartz Daniel, Harrop James S, Weinstein Michael
Department of Neurosurgery, Jefferson Medical College, Philadelphia, Pennsylvania 19107, USA.
J Spinal Cord Med. 2009;32(4):432-5. doi: 10.1080/10790268.2009.11753252.
Femoral nerve palsy is not a common adverse effect of lumbar spinal surgery.
To report 3 unique cases of femoral nerve neuropathy due to instrumentation and positioning during complex anterior and posterior spinal surgery.
Case series
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.
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.