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Transient Meralgia Paresthetica After Pediatric Posterior Spine Fusion

Tejwani, Samir G. MD*; Scaduto, Anthony A. MD; Bowen, Richard E. MD

Journal of Pediatric Orthopaedics: July-August 2006 - Volume 26 - Issue 4 - p 530-533
doi: 10.1097/01.bpo.0000217721.95480.9e
Selected Topics: Original Article
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Abstract: Meralgia paresthetica (MP) rarely occurs during posterior spine surgery. The study goal was to examine risk factors associated with the incidence of MP. A review of 56 consecutive pediatric patients undergoing posterior spine fusion for scoliosis was performed. Patients with abnormal sensation in the lateral thigh preoperatively and prior spine surgery were excluded. All patients were positioned prone on the Jackson (Orthopaedic Systems, Inc., Union City, CA) spinal table with either (1) the lower leg support table and thigh supports or (2) the lower leg suspension sling. Data on patient weight, diagnosis, surgeon, duration of surgery, presence of MP, symptoms, and symptom duration were collected. A logistic regression analysis was performed between independent variables and presence of MP. There were 10/56 patients with MP (18%). Symptoms were anterolateral thigh numbness without pain or weakness. Symptoms in all cases were resolved, on average, before the 6-week postoperative visit (range 2-24 weeks). Patients with MP more often had idiopathic scoliosis (28% vs 7%; P < 0.05) were positioned with the lower leg sling instead of the flat table support (31% vs 13%; P < 0.05) and trended toward longer surgery times (451 vs 388 minutes; NS). Abnormal body mass index, age at surgery, surgeon, and sex did not correlate to MP. MP can occur after pediatric posterior spine surgery. Symptoms were minor, temporary, and did not require treatment. Shorter surgical times and use of thigh pads in conjunction with the lower leg support table may decrease the incidence of MP.

From the *Department of Orthopaedic Surgery, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA; and the †Department of Orthopaedic Surgery, Shriners Hospitals for Children, Los Angeles Unit, Los Angeles, CA.

Investigation was performed at the Shriners Hospitals for Children, Los Angeles, CA.

None of the authors received financial support for this study.

Reprints: Richard E. Bowen, MD, Shriners Hospitals for Children, Los Angeles Unit, 3160 Geneva Street, Los Angeles, CA 90020. E-mail: rbowen@shrinenet.org.

© 2006 Lippincott Williams & Wilkins, Inc.