General Information
Lateral Cutaneous Nerve of Thigh (LCNT) decompression is a standard procedure for the treatment of Meralgia paresthetica, which is caused by compression of the LCNT when it passes under the Inguinal Ligament at the groin area to supply the anterior and lateral aspect of the thigh with sensation.
Target and Result: The results of surgery are generally good. However, complications can occur as finding the area of compression can be very difficult. Complete transaction of the nerve is an option, but it would the patient would be left with a permanent area of numbness at the Anterio-Lateral aspect of the thigh.
Risk of complications
- The Risk of Infection is less than 2%. It may affect the superficial tissues and skin, or may affect the deep structures around the nerve and the tendons of the muscles, which is very rare.
- Bleeding ,which may lead to hematoma collection that needs further surgery.
- Failure to improve symptoms with progression of the condition related nerve damage and scarring, therefore, unlikely to respond to surgery.
- General anesthetic complications (heart attack, stroke), local anesthetic allergic reaction.
- Deep venous thrombosis/pulmonary embolism (clots in legs / lungs) in cases of general anesthesia surgery.
The Procedure
- LCNT decompression is a standard procedure that is carried out on routine base.
- The procedure is usually done under general anesthesia, but can be done under LA, according to the patient preferences.
- It lasts approximately 30 minutes. When it’s done under LA, the patient is usually kept awake; local anesthetic infiltration is the only painful step in the procedure.
- During the procedure, the surgeon will communicate with the patient, and depending on whether they feels any pain or discomfort, further infiltration of the LA will be done.
- It involves making 5 cm incision at groin area, dissection to expose the nerve under the inguinal ligament.
- The target is freeing the nerve proximally under inguinal ligament.
- The wound is closed in layers with dissolvable stitches; skin is closed with Nylon stitches which need to be removed in 10 days.
Aftermath
- Most patients will go home after 2-4 hours and will be recovering at home for approximately 4 weeks.
- Patient should avoid heavy weight lifting and heavy physical activity for 4 weeks.
- Following surgery the patient may notice some pain and stiffness but this should settle with simple pain killers.
- Further outpatient physiotherapy sessions will be offered, where indicated.
- Patient is usually followed up in the clinic in 8-12 weeks after surgery. If any complication happens, the patient will stay until everything gets sorted.
- All regular medication will continue except the blood thinning medication like Warfarin, Apixoban, Aspirin, cloidogrel etc, needs advised individually. Most of the cases can started after 48h from the surgery.