Success rates of a surgical neurectomy for lateral cutaneous nerve entrapment syndrome (LACNES).

Abstract

Objectives: Chronic flank pain is occasionally due to entrapped lateral end branches of intercostal nerves (lateral cutaneous nerve entrapment syndrome, LACNES). If local injection therapy fails, a neurectomy may be considered. The literature on LACNES is limited to case reports and a small case series. Aim of the present study is to determine short- and long-term success rates of a neurectomy in a large group of patients with LACNES.

Methods: All adult patients who underwent a neurectomy for LACNES between January 2012 and December 2022 in a single centre of expertise were asked to complete a questionnaire regarding their current pain levels. Primary objectives were short-term (6-12 weeks postoperatively) and long-term (>6 months postoperatively) treatment outcome. A successful outcome was defined as a minimal 50 % pain reduction.

Results: Data from 54 of 69 operated patients (81 % female, mean age 47 years) were analysed (78 % response rate). Baseline characteristics of responders and non-responders were not different. A 67 % short-term success rate was observed (n=36). Long-term outcome remained successful in 23 patients (43 %, mean follow-up 23 months). Ten patients had minor complications (delayed wound healing n=6, hematoma n=3, deep vein thrombosis n=1; all recovered after conservative treatment).

Conclusions: If local injection therapy fails in LACNES, a lateral neurectomy should be discussed. Approximately half of patients report success on the long-term.

Trial registration: The Local Medical Ethics Committee of Máxima Medical Centre number N20.125.