Center for Anatomy and Cell Biology, Medical University of Vienna, Waehringer Strasse 13, 1090 Vienna, Austria; Department of Neurosurgery, Neuromed Campus, Kepler University Hospital, Johannes Kepler University, Wagner-Jauregg-Weg 15, 4020 Linz, Austria.
Center for Anatomy and Cell Biology, Medical University of Vienna, Waehringer Strasse 13, 1090 Vienna, Austria.
Pain Physician. 2020 Jul;23(4):E363-E368.
Ultrasound-guided perineural injections at the lateral femoral cutaneous nerve (LFCN) may confirm the correct diagnosis and provide symptom relief in meralgia paresthetica. Although correct visualization of the nerve is generally described as feasible, failure rates of the procedure may be as high as 30%.
This study investigated the spread of injected fluids in ultrasound-guided perineural injections at the LFCN. The aim of the study was to evaluate whether the inguinal ligament impedes the distribution of injected fluids along the course of the LFCN.
We used a descriptive research design.
Research was conducted at an anatomical research facility.
In fresh, nonembalmed cadavers, 2 mL of ink were injected with ultrasound-guidance at the LFCN below the inguinal ligament. The course of the nerve was then dissected to show the extent of nerve staining.
Spread of the injected ink proximal to the inguinal ligament was found in 67.65% of specimens, while the ink did not pass the inguinal ligament in 32.35%. Concerning proximal spread, specimen body mass index was not of any relevance.
This cadaver study is only a simulation of the real clinical setting and does not allow any insight into the efficacy of the injection in living patients.
The inguinal ligament is a barrier in the distribution of injected fluids in about one-third of specimens. This might be a major cause of failure in ultrasound-guided injections. The results from our study are in line with previously published failure rates and our findings might provide the anatomic basis to advance injection techniques.
Cadaver study; injection; lateral femoral cutaneous nerve; LFCN; meralgia paresthetica; nerve entrapment; sonography; ultrasound.
超声引导下股外侧皮神经（LFCN）旁神经内注射可明确诊断并缓解感觉异常性股痛。尽管通常认为可清晰显示神经，但该操作的失败率可能高达 30%。
本研究旨在探讨超声引导下 LFCN 旁神经内注射时注射液的扩散情况。本研究旨在评估腹股沟韧带是否会阻碍注射液沿 LFCN 分布。
我们采用描述性研究设计。
在解剖学研究机构进行研究。
在新鲜、未经防腐处理的尸体中，在腹股沟韧带下方使用超声引导注射 2 mL 墨水。然后解剖神经以显示神经染色的程度。
在 67.65%的标本中，注射墨水可扩散至腹股沟韧带近端，而在 32.35%的标本中，墨水无法穿过腹股沟韧带。关于近端扩散，标本体重指数没有任何相关性。
本尸体研究仅模拟了真实的临床环境，无法了解注射在活体患者中的效果。
腹股沟韧带是注射液在大约三分之一标本中分布的障碍。这可能是超声引导注射失败的主要原因。我们的研究结果与先前发表的失败率一致，我们的发现可能为改进注射技术提供解剖学基础。
尸体研究；注射；股外侧皮神经；LFCN；感觉异常性股痛；神经卡压；超声检查；超声。
