The surgical anatomy of the lateral femoral cutaneous nerve in the inguinal region: a meta-analysis

K A Tomaszewski, P Popieluszko, B M Henry, J Roy, B Sanna, M R Kijek, J A Walocha, K A Tomaszewski, P Popieluszko, B M Henry, J Roy, B Sanna, M R Kijek, J A Walocha

Abstract

Purpose: Several variations in the anatomy and injury of the lateral femoral cutaneous nerve (LFCN) have been studied since 1885. The aim of our study was to analyze the available data on the LFCN and find a true prevalence to help in the planning and execution of surgical procedures in the area of the pelvis, namely inguinal hernia repair.

Methods: A search of the major medical databases was performed for LFCN anatomy. The anatomical data were collected and analyzed.

Results: Twenty-four studies (n = 1,720) were included. The most common pattern of the LFCN exiting the pelvis was medial to the Sartorius as a single branch. When it exited in this pattern, it did so on average 1.90 cm medial to the anterior superior iliac spine (ASIS).

Conclusions: The LFCN and its variations are important to consider especially during inguinal hernia repair, abdominoplasty, and iliac bone grafting. We suggest maintaining a distance of 3 cm or more from the ASIS when operating to prevent injury to the LFCN.

Keywords: Anatomy; Lateral femoral cutaneous nerve; Meta-analysis; Variations.

Conflict of interest statement

Compliance with ethical standards This study complies with the current laws of the country in which they were performed. Conflict of interest Krzysztof A. Tomaszewski, Patrick Popieluszko, Brandon Michael Henry, Joyeeta Roy, Beatrice Sanna, Mark Robert Kijek, and Jerzy A. Walocha declare that they have no conflict of interest. Research involving human participants and/or animals This article does not contain any studies with human participants or animals performed by any of the authors. Informed consent This article does not require informed consent due to the lack of human participants.

Figures

Fig. 1
Fig. 1
PRISMA flowchart of studies included in the meta-analysis
Fig. 2
Fig. 2
Types of exits of the lateral femoral cutaneous nerve from the pelvis with calculated pooled prevalence. Type 1 medial to the sartorius (under the IL and medial to the ASIS), type 2 through the IL, type 3 over the IL, type 4 over the ASIS, type 5 lateral (or behind) the ASIS, type 6 through the ASIS, type 7 through the sartorius. All data reported as pooled prevalence in percentage with 95 % confidence intervals. PMa psoas major, PMi psoas minor, IM iliacus muscle, Sa sartorius, TFL tensor fasciae latae, IL inguinal ligament, LFCN lateral femoral cutaneous nerve, ASIS anterior superior iliac spine, QL quadratus lumborum

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