Successful Application of Spinal Cord Stimulation in a Patient with Refractory Bilateral Meralgia Paresthetica

Abstract

We present a 38-year-old morbidly obese male who presented with functionally limiting bilateral anterior thigh pain consistent with meralgia paresthetica. His symptoms had been unresponsive to conservative measures which included physical therapy, oral medications and multiple nerve blocks. Patient underwent a trial of spinal cord stimulation (SCS), experiencing 70% of pain relief. He then underwent permanent SCS implant. At subsequent follow-ups 3 and 6 months later, he continued to report 70% improvement of his pain, as well as improved function and quality of life. To our knowledge, this is only the second reported case of successful treatment of meralgia paresthetica with SCS, and the first in a morbidly obese patient.

Lay abstract

We report a case of a 38-year-old obese male who presented with meralgia paresthetica, a condition characterized by abnormal sensation and nerve pain to the outer aspect of the thigh, limiting his ability to perform activities of daily living. His pain was unresponsive to multiple treatment options such as physical therapy, oral medications and a series of injections with local anesthetic and corticosteroid medications. We then proceeded with spinal cord stimulation, which consists of implanting a device that provides low levels of electrical current to the spinal cord, in hopes of alleviating his pain. After implantation of the device, at 3- and 6-month follow-ups, he was able to achieve 70% improvement of his pain, with the ability to perform his daily activities. This is the second case reported of the use of spinal cord stimulation for this type of condition.

Keywords::

• high frequency spinal cord stimulation
• lateral femoral cutaneous nerve
• lateral femoral cutaneous neuropathy
• meralgia paresthetica
• spinal cord stimulation
• spinal cord stimulator

Acknowledgments

The authors would like to thank Dr Jackson Cohen from Memorial Healthcare System, Department of Physical Medicine & Rehabilitation, Division of Pain Medicine, for his expertise and assistance with the implantation of the permanent spinal cord stimulator in our patient.

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

Informed consent disclosure

The authors state that they have obtained appropriate institutional review board approval or have followed the principles outlined in the Declaration of Helsinki for all human or animal experimental investigations. In addition, for investigations involving human subjects, informed consent has been obtained from the participants involved. The authors state that they have obtained verbal and written informed consent from the patient for the inclusion of their medical and treatment history within this case report.