Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Department of Anesthesiology and Perioperative Medicine, Division of Pain Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Pain Med. 2021 Feb 4;22(1):213-216. doi: 10.1093/pm/pnaa326.
Meralgia paresthetica is a condition caused by entrapment of the lateral femoral cutaneous nerve that leads to paresthesia along the anterolateral portion of the thigh. Because of advancements in neuromodulation, peripheral nerve stimulation (PNS) has been considered a new treatment option for meralgia paresthetica. Newer PNS technology targets peripheral nerves directly yet in a minimally invasive manner. We report a case in which a PNS device provided more than 12 months of complete pain relief in a patient with meralgia paresthetica and helped the patient avoid a neurolysis procedure.
A 57-year-old male presented to clinic with a 6-year history of "painful numbness [and] burning" along the right lateral thigh. He rated his pain as 8 out of 10, which decreased to a rating of 2 out of 10 with the use of gabapentin, but unwanted side effects motivated him to seek alternative treatment. On the basis of his history, physical exam, and imaging results, he was diagnosed with meralgia paresthetica. He was offered neurolysis; however, after seeing a pain specialist, he agreed to the implantation of a SPRINT peripheral nerve stimulator. After the implantation procedure, his pain reduced to 0 out of 10, and his quality of life improved, with better sleep and less somnolence. The device was removed after 60 days, as planned. He continued to have complete resolution of pain at 12 months after the date of device implantation.
With recent advancements, PNS can be used to treat meralgia paresthetica in an effective yet minimally invasive manner. As newer PNS technology becomes more familiar to physicians and pain specialists, it is likely to be used as a mainstay treatment for meralgia paresthetica.
股外侧皮神经炎是一种由股外侧皮神经受压引起的疾病，导致大腿前外侧部分出现感觉异常。由于神经调节技术的进步，外周神经刺激（PNS）已被认为是治疗股外侧皮神经炎的一种新的治疗选择。较新的 PNS 技术以微创的方式直接针对外周神经。我们报告了一例 PNS 设备为股外侧皮神经炎患者提供超过 12 个月完全缓解疼痛的病例，并帮助患者避免神经松解术。
一名 57 岁男性因右侧大腿外侧“疼痛性麻木[和]烧灼感”就诊，病史 6 年。他的疼痛评分为 8 分（满分 10 分），使用加巴喷丁后疼痛评分降至 2 分，但因出现不良反应而促使他寻求替代治疗。根据他的病史、体格检查和影像学结果，他被诊断为股外侧皮神经炎。他被建议进行神经松解术；然而，在看了疼痛专家后，他同意植入 SPRINT 外周神经刺激器。植入手术后，他的疼痛减轻到 0 分（满分 10 分），生活质量提高，睡眠更好，嗜睡减少。按照计划，60 天后取出了设备。植入设备后 12 个月，他的疼痛完全缓解。
随着最近的技术进步，PNS 可以有效地治疗股外侧皮神经炎，且采用微创方式。随着较新的 PNS 技术在医生和疼痛专家中越来越熟悉，它可能会成为股外侧皮神经炎的主要治疗方法。
