Prone position-related meralgia paresthetica after lumbar spinal surgery : a case report and review of the literature

Abstract

Lateral femoral cutaneous neuropathy occurring during spinal surgery is frequently related to iliac bone graft harvesting, but meralgia paresthetica (MP) can result from the patient being in the prone position. Prone position-related MP is not an uncommon complication after posterior spine surgery but there are only few reports in the literature on this subject. It is usually overlooked because of its mild symptoms and self-limiting course, or patients and physicians may misunderstand the persistence of lower extremity symptoms in the early postoperative period to be a reflection of poor surgical outcome. The authors report a case of prone position-related MP after posterior lumbar interbody fusion at the L3-4 and reviewed the literature with discussion on the incidence, pathogenesis, and possible risk factors related to this entity.

Keywords: Lateral femoral cutaneous nerve (LFCN); Meralgia paresthetica (MP); Posterior spinal surgery; Prone position.

Fig. 1

Postoperative simple lateral radiograph of lumbar spine (A), axial computed tomography scans of the L3 pedicle (B), intervertebral cages (C), and L4 pedicle (D) reveal no violation of the medial wall of pedicle by the pedicle screws and proper position of the right-sided intervertebral cage.