Postoperative Bilateral Meralgia Paresthetica after Spine Surgery : An Overlooked Entity?

The idiopathic meralgia paresthetica is well known and was related with plenty of etiologies; however the bilateral meralgia paresthecia (BMP) after spine surgery, as unexpected complications, has sparsely been reported in the literature. The objetive of this study is to describe the BMP and to evaluate the prevalence in the setting of low thoracic and lumbar spine surgery. During the 10-years-period from 1991 through 2001, data from every patient harboring surgical procedure on the low-thoracic, lumbar and/or sacral spine were evaluated. Eighty three patients were collected. A total of 59 patients, as having markedly sensory disturbance or younger than 15 year-old, were excluded from the study. Among the remaining 24 patients, we found five cases (20, 8%) in which the BMP appeared postoperatively. The BMP was characterized by the postopertive onset of bilateral exquisite sensory disturbance upon the antero-lateral region of the thigh. All of them were young (average age of 27 years), and slender (median of Body Mass Index : 21.22 Kg/m^2). Tumor removal was done for three patients and cord untethering was performed for other two patients. All patients recovered completely with conservative management for 1, 5 to 11 months. In conclusion, we reported five cases of BMP after spinal surgery in prone position. Young slender patients are at risk in contrast to idiopathic meralgia. It may be avoided by improving frame system and meticulous attention but can happen due to anatomical variation of the LFCN.