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Case Reports
. 2009;32(4):432-5.
doi: 10.1080/10790268.2009.11753252.

Vulnerability of the femoral nerve during complex anterior and posterior spinal surgery

Swetha Naroji  1 , Laurence J Belin, Mitchell Gil Maltenfort, Alexander R Vaccaro, Daniel Schwartz, James S Harrop, Michael Weinstein
Affiliations
Case Reports

Vulnerability of the femoral nerve during complex anterior and posterior spinal surgery

Swetha Naroji et al. J Spinal Cord Med. 2009.

Abstract

Background: Femoral nerve palsy is not a common adverse effect of lumbar spinal surgery.

Objective: To report 3 unique cases of femoral nerve neuropathy due to instrumentation and positioning during complex anterior and posterior spinal surgery.

Methods: Case series

Results: 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.

Conclusions: 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.

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Figures

Figure 1
Figure 1. Postoperative films of case 1 before the revision surgery. Although the films showed good positioning of the instrumentation, the patient developed femoral neuropathy that resolved 6 months later.
Figure 2
Figure 2. Postoperative films of case 2. The posterior instrumentation of L4 to S1 and the anterior instrumentation of L4 to L5 shows good placement. The patient showed no further neuropathies.
See this image and copyright information in PMC

References

    1. Kim DH, Murovic JA, Tiel RL, Kline DG. Intrapelvic and thigh-level femoral nerve lesions: management and outcomes in 119 surgically treated cases. J Neurosurg. 2004;100(6):989–996. - PubMed
    1. Fardin P, Bettello P, Negrin P. Iatrogenic femoral neuropathy: considerations on its prognosis. Electromyogr Clin Neurophysiol. 1980;20(2):153–155. - PubMed
    1. Kim DH, Kline DG. Surgical outcome for intra- and extrapelvic femoral nerve lesions. J Neurosurg. 1995;83(5):783–790. - PubMed
    1. Weber ER, Daube JR, Coventry MB. Peripheral neuropathies associated with total hip arthroplasty. J Bone Joint Surg Am. 1976;58(1):66–69. - PubMed
    1. Kourtopoulos H. Femoral nerve injury following appendectomy. J Neurosurg. 1982;57(5):714–715. - PubMed

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