Variations of the extrapsoas course of the lumbar plexus with implications for the lateral transpsoas approach to the lumbar spine: a cadaveric study.

BACKGROUND: Together with an increased interest in minimally invasive lateral transpsoas approach to the lumbar spine goes a demand for detailed anatomical descriptions of the lumbar plexus. Although definitions of safe zones and essential descriptions of topographical anatomy have been presented in several studies, the existing literature expects standard appearance of the neural structures. Therefore, the aim of this study was to investigate the variability of the extrapsoas portion of the lumbar plexus in regard to the lateral transpsoas approach. METHODS: A total of 260 lumbar regions from embalmed cadavers were utilized in this study. The specimens were dissected as per protocol and all nerves from the lumbar plexus were morphologically evaluated. RESULTS: The most common variation of the iliohypogastric and ilioinguinal nerves was fusion of these two nerves (9.6%). Nearly in the half of the cases (48.1%) the genitofemoral nerve left the psoas major muscle already divided into the femoral and genital branches. The lateral femoral cutaneous nerve was the least variable one as it resembled its normal morphology in 95.0% of cases. Regarding the variant origins of the femoral nerve, there was a low formation outside the psoas major muscle in 3.8% of cases. The obturator nerve was not variable at its emergence point but frequently branched (40.4%) before entering the obturator canal. In addition to the proper femoral and obturator nerves, accessory nerves were present in 12.3% and 9.2% of cases, respectively. CONCLUSION: Nerves of the lumbar plexus frequently show atypical anatomy outside the psoas major muscle. The presented study provides a compendious information source of the possibly encountered neural variations during retroperitoneal access to different segments of the lumbar spine.

Exoscope for revision of right lateral femoral cutaneous nerve decompression.

The exoscope serves as a valuable addition or alternative to traditional microscope systems in surgery, offering 3D visualization and magnification with enhanced maneuverability. In lateral femoral cutaneous nerve decompression for meralgia paresthetica, the exoscope is effective in identifying strictures of neural compression and minimizing iatrogenic nerve damage that may lead to improved pain management outcomes for patients. In this report, the specific case presented showcases how the exoscope aided in surgical decompression of the lateral femoral cutaneous nerve of a patient with refractory meralgia paresthetica with remote previous decompression and resultant scarring. The video can be found here: https://stream.cadmore.media/r10.3171/2023.10.FOCVID23162.

Peripheral Nerve Blocks for Hip Fractures.

The incidence of hip fractures has continued to increase as life expectancy increases. Hip fracture is one of the leading causes of increased morbidity and mortality in the geriatric population. Early surgical treatment (<48 h) is often recommended to reduce morbidity/mortality. In addition, adequate pain management is crucial to optimize functional recovery and early mobilization. Pain management often consists of multimodal therapy which includes non-opioids, opioids, and regional anesthesia techniques. In this review, we describe the anatomical innervation of the hip joint and summarize the commonly used peripheral nerve blocks to provide pain relief for hip fractures. We also outline literature evidence that shows each block's efficacy in providing adequate pain relief. The recent discovery of a nerve block that may provide adequate sensory blockade of the posterior capsule of the hip is also described. Finally, we report a surgeon's perspective on nerve blocks for hip fractures.

Meralgia Paresthetica-An Approach Specific Neurological Complication in Patients Undergoing DAA Total Hip Replacement: Anatomical and Clinical Considerations.

Introduction: Mini-invasive surgical (MIS) approaches to total hip replacement (THR) are becoming more popular and increasingly adapted into practice. THR via the direct anterior approach (MIS DAA) has become a rather controversial topic in hip arthroplasty literature in the last decades. Our retrospective observational study focuses on the prevalence of one approach-specific complication-lateral femoral cutaneous nerve (LFCN) iatrogenic lesion-and tries to clarify the possible pathogenesis of this injury. Methods: This is a retrospective single-cohort observational single-center and single-surgeon study. Our patient records were searched for the period from 2015 to 2017-after a safe period of time after the learning curve for MIS DAA. All intra- and post-operative lesions of the LFCN were recorded. Lesion of the LFCN was confirmed by a neurological examination. Minimum patient follow-up was 2 years. Results: This study involved 417 patients undergoing single-side THR via MIS DAA. Patients were examined on follow-up visits at 6 weeks, 6 months, 1 year, and 2 years after surgery. There were 17 cases of LCFN injury at the 6 weeks early follow-up visit (4.1%). All cases of clinically presenting LFCN injury resolved at the 2-year follow-up ad integrum. Discussion: Possible explanations of such neurological complications are direct iatrogenic injury, vigorous traction, hyperextension, or extreme external rotation of the operated limb. Use of a traction table or concomitant spinal pathology and deformity also play a role. Prevention involves stepwise adaptation of the approach during the learning curve period by attending cadaver lab courses, rational use of traction and hyperextension, and careful surgical technique in the superficial and deep fascial layers. Dynamometers could be used to visualise the limits of manipulation of the operated limb. Conclusions: Neurological complications are not as rare but questionably significant in patients undergoing THR via the DAA. Incidental finding of LFCN injury has no effect on the functional outcome of the artificial joint. It can lead to lower subjective satisfaction of patients with the operation, which can be avoided with careful education and management of expectations of the patients.

Characteristics, reliability, and quality of YouTube videos on meralgia paresthetica: a descriptive cross-sectional study.

INTRODUCTION: The purpose of this study was to evaluate YouTube videos on meralgia paresthetica (MP) for reliability, quality, and differences between quality levels. METHODS: We analyzed 59 videos related to MP. We evaluated several video characteristics, including views, likes, dislikes, duration, and speaker profile. We used view ratio, like ratio, Video Power Index (VPI), Global Quality Scale (GQS), JAMA criteria, and modified DISCERN (mDISCERN) to assess viewer engagement, popularity, educational quality, and reliability. RESULTS: The videos received a total of 4,009,141 views (average 67,951.54), with 25.4% focused on exercise training and 23.7% focused on disease information. Mean scores were mDISCERN 2.4, GQS 2.8, and JAMA 2.1. Physician-led videos had higher mDISCERN scores, while allied health worker-led videos had more views, likes, dislikes, view ratios, and VPI. Poor and high-quality videos differed in views, likes, view ratio, VPI, and duration. Positive correlations existed among mDISCERN, JAMA, and GQS scores, with video duration positively correlated with GQS. CONCLUSION: The content of YouTube videos discussing diseases significantly influences viewer engagement and popularity. To enhance the availability of valuable content on YouTube, which lacks a peer review process, medical professionals must contribute high-quality educational materials tailored to their target audience.

Meralgia paresthetica.

Meralgia paresthetica is a common but probably underrecognized syndrome caused by dysfunction of the lateral femoral cutaneous nerve. The diagnosis is based on the patient's description of sensory disturbance, often painful, on the anterolateral aspect of the thigh, with normal strength and reflexes. Sensory nerve conduction studies and somatosensory evoked potentials may be used to support the diagnosis, but both have technical limitations, with low specificity and sensitivity. Risk factors for meralgia paresthetica include obesity, tight clothing, and diabetes mellitus. Some cases are complications of hip or lumbar spine surgery. Most cases are self-limited, but a small proportion of patients remain with refractory and disabling symptoms. Treatment options include medications for neuropathic pain, neurolysis, neurectomy, and radioablation, but controlled trials to compare efficacy are lacking.

Use of lateral femoral cutaneous nerve blocks by landmark technique is ineffective in decreasing narcotic usage after skin grafts: A retrospective case-control study.

INTRODUCTION: Cutaneous burns are commonly treated with autologous skin grafts. Following skin grafting, many patients complain of pain at the donor site. Donor sites are taken most commonly from the lateral thigh, which is innervated by the lateral femoral cutaneous nerve (LFCN). Use of a LFCN blocks should decrease nociception from the donor site. METHODS: Our group began utilizing LFCN blocks in 2019. Utilizing anatomic landmarks, LFCN blocks were performed on all patients who received autologous skin grafts to reduce perioperative pain. A retrospective cohort study was performed on all patients with 10% or less total body surface areas burns who received an autologous skin graft. A similar cohort from 2016, prior to use of any local or regional analgesia, was used as a historical control. Post-operative enteral and parenteral narcotic analgesics were collected for each post-operative day up to day 5 or discharge (whichever came first) and converted to morphine milligram equivalents (MME) to quantify analgesia after surgery. RESULTS: Chart review identified 55 patients in the 2020 cohort. Fifty-five patients from the 2016 cohort were matched based upon size of skin graft, total body surface area (TBSA) burned, gender, and age. There were no statistically significant differences between the two groups in terms of size of graft, TBSA burned, age, gender, or type of burn. When examining narcotics usage in the immediate perioperative period (days 0-2), we found no difference between the two groups for total MME (113 vs 133, p = 0.28) or IV MME (38 vs 33, p = 0.45). Similar relationships existed in the extended post-operative period (days 1-5) for total MME (149 vs. 188, t = 0.22) or IV MME (37 vs. 50, t = 0.25). Examining daily narcotic usage also yielded no statistically different values. CONCLUSION: Our data shows that use of LFCN block by landmark technique did not reduce narcotic usage in patients that undergo skin grafting procedures. Future studies should consider ultrasound-guided LFCN blocks.

Lateral Femoral Cutaneous Nerve Cryoneurolysis for Meralgia Paresthetica: A Case Report.

Meralgia paresthetica (MP) is a disorder of lateral femoral cutaneous nerve mononeuropathy caused by entrapment or compression of the nerve. It is characterized by numbing, tingling, and burning pain in the lateral aspect of the thigh. The current treatments for MP include conventional medical management, peripheral nerve blocks, and surgical interventions. Some patients who suffer from MP can experience intractable pain and medical management of MP is often inadequate to provide satisfactory pain control. Although regional anesthesia provides excellent pain relief, the analgesic effects of peripheral nerve block are short-lived. Emerging evidence suggests that cryoneurolysis has a low-risk safety profile and can provide prolonged pain relief of superficial nerves when administered appropriately. We present a successful case of a patient with intractable neuropathic pain resulting from MP treated with cryoneurolysis therapy. The patient demonstrated immediate pain relief by 100% after the procedure followed by 80% and 60% pain reduction at 1-month and 3-months follow-up, respectively. Cryoneurolysis may be an alternative modality for patients who fail at conventional medical treatments of neuropathic pain.

Morphological variability of lateral femoral cutaneous nerve and its potential clinical significance.

BACKGROUND: The lateral femoral cutaneous nerve is derived from the dorsal branches of the L2 and L3 spinal nerves. It travels across the pelvis and heads towards the anterior superior iliac spine. It passes under the lateral part of the inguinal ligament and then divides into two branches, which are responsible for sensory innervation of the anterolateral and lateral skin of the thigh. However, the course of this nerve can vary morphologically. Numerous differences have been observed in its exit from the pelvis and in the number of its main trunks and branches. Additionally, its angle with the inguinal ligament and its placement in relation to other structures (such as the femoral artery, femoral nerve, and the sartorius and iliacus muscles) also vary. All of these variants have potential clinical implications. Therefore, the aim of this review is to present the morphological variability of the lateral cutaneous nerve and to explore how these anatomical differences can introduce clinical concerns. MATERIALS AND METHODS: Presented review of the literature was written based on over 30 studies. Comprehensive literature search was done using PubMed in order to study the morphological variability of lateral femoral cutaneous nerve (LFCN). To be included in this review studies needed to be meet certain criteria: been published before December 2023, present information valuable to this paper (variability of lateral femoral cutaneous nerve/clinical significance). The search included how LFCN vary either among fetuses and adults in the aim of providing more complex information about the variability of this nerve. During the search key words as following were used. No particular references were excluded from the analysis. All relevant studies were included, and citation tracking was used to identify publications. RESULTS: This review presents the description of variability of LFCN and its potential clinical impact. In the review differences in adult and fetuses were considered, morphological variability were divided into 4 groups: the origin of the nerve, the way it leaves the pelvis, the branching pattern, the angle between LFCN and surrounding structures and then, clinical significance were considered basing on available literature.

Lateral Femoral Cutaneous Nerve Block for Postoperative Pain Control After Total Hip Arthroplasty Using the Direct Anterior Approach: A Single-blinded Randomized Control Trial.

Background: Total hip arthroplasty (THA) employing the direct anterior approach (DAA) is increasingly performed as a less invasive procedure with faster recovery than other approaches. Unlike other approaches, the skin incision is made on the lateral thigh, distal to the inguinal ligament. However, the effectiveness of ultrasound-guided lateral femoral cutaneous nerve (LFCN) block for postoperative analgesia after THA using DAA has not been investigated.We hypothesized that ultrasound-guided LFCN block using DAA would reduce postoperative pain after THA. Methods: A prospective, randomized, observer-blinded controlled trial was conducted. The 92 patients included were divided into two groups: those who received only femoral nerve block (FNB group) and those who received femoral nerve block and LFCN block with 10mL of 0.25% levobupivacaine (FNB + LFCNB group). Both groups received intravenous patient-controlled analgesia (fentanyl) postoperatively. A numerical rating scale was used to quantify pain at 3 and 48 h postoperatively. Results: There was no significant difference in pain at rest and during movement between the FNB and FNB + LFCNB groups (at rest: Z = -1.6814, p=0.0927; during on movement: Z = -0.9677, p=0.9487). There was also no significant difference in pain severity at rest and during movement between the FNB and FNB + LFCNB groups postoperatively. Conclusions: LFCNB did not improve postoperative pain relief in patients undergoing THA with DAA.

Prevalence and management of refractory meralgia paresthetica in lumbar spine surgery: 5 years of experience / Prevalência e manejo da meralgia parestésica refratária em cirurgia de coluna lombar: experiência de cinco anos / Prevalencia y manejo de la meralgia parestésica refractaria en cirugía de columna lumbar: experiencia de 5 años

ABSTRACT Objective The objective of our study was to report 5 years of experience in the recognition and management of refractory meralgia paresthetica (MP) in patients who had undergone posterior approach lumbar surgery. Methods Patients who were submitted to procedures in the lumbar spine from January 2010 to January 2015 in three different hospital centers in Belo Horizonte/MG were selected for an evaluation of the postoperative development of MP. A prospective observational comparative case series study. Level of evidence III. Evaluation of the following parameters: type of support for the patient, surgical time, body mass index. Results 367 posterior approach lumbar spine surgeries for degenerative pathologies of the lumbar spine were performed. MP was observed in 81 patients (22%). In 65 of those patients (80%), there was complete resolution of the symptoms with conservative management (local measures and medications for neuropathic pain) in less than two months. Twelve patients improved with a corticosteroid depot injection in the inguinal ligament and four patients required a surgical procedure in the third month. Pneumatic support was the least involved in the development of MP, as well as surgical time <1h and body mass index <25. Conclusion Refractory MP may occur in patients submitted to posterior approach lumbar spine surgeries. Management includes local measures, medications for neuropathic pain, and corticosteroid injection in the inguinal ligament. Decompression surgery is reserved for rare refractory cases. Level of evidence III; Prospective observational study with comparative case series.

RESUMO Objetivo O objetivo do presente estudo consiste em relatar a experiência de cinco anos no reconhecimento e manejo da meralgia parestésica (MP) refratária em pacientes submetidos a cirurgias lombares por via posterior. Métodos Pacientes submetidos a procedimentos na coluna lombar, no período de janeiro de 2010 a janeiro de 2015, em três diferentes centros hospitalares de Belo Horizonte/MG, foram selecionados para avaliação do desenvolvimento da MP pós-operatória. Estudo prospectivo observacional com série de casos comparativos. Nível III de evidência. Avaliação dos seguintes parâmetros: tipo de suporte para o paciente, tempo de cirurgia, índice de massa corporal. Resultados Foram feitas 367 cirurgias por via posterior da coluna lombar para patologias degenerativas da coluna lombar. A MP foi observada em 81 pacientes (22%). Em 65 pacientes (80%), houve resolução completa dos sintomas com manejo conservador (medidas locais e medicamentos para dor neuropática) em menos de dois meses. Doze pacientes melhoraram através de infiltração com corticoide de depósito e anestésico no local no ligamento inguinal e, em quatro pacientes houve necessidade de procedimento cirúrgico no terceiro mês. O suporte pneumático foi o menos envolvido no desenvolvimento da MP, assim como o tempo cirúrgico <1h e índice de massa corporal <25. Conclusão A MP refratária pode ocorrer em pacientes submetidos a cirurgias na coluna lombar por via posterior. O manejo inclui medidas locais, medicamentos para dor neuropática e infiltração com corticoide no ligamento inguinal. A cirurgia descompressiva está reservada para os raros casos refratários. Nível de evidência III; Estudo prospectivo observacional com série de casos comparativos.

RESUMEN Objetivo El objetivo del presente estudio consiste en relatar la experiencia de 5 años en el reconocimiento y manejo de la meralgia parestésica (MP) refractaria en pacientes sometidos a cirugías lumbares por vía posterior. Métodos Pacientes sometidos a procedimientos en la columna lumbar, en el período de enero de 2010 a enero de 2015, en tres diferentes centros hospitalarios de Belo Horizonte/MG, fueron seleccionados para evaluación del desarrollo de la MP postoperatoria. Estudio prospectivo observacional con serie de casos comparativos. Nivel III de evidencia. Evaluación de los siguientes parámetros: tipo de soporte para el paciente, tiempo de cirugía, índice de masa corporal. Resultados Se realizaron 367 cirugías por vía posterior de la columna lumbar para patologías degenerativas de la columna lumbar. La MP fue observada en 81 pacientes (22%). En 65 pacientes (80%) hubo resolución completa de los síntomas con manejo conservador (medidas locales y medicamentos para el dolor neuropático) en menos de 2 meses. Doce pacientes mejoraron a través de infiltración de corticoide de depósito y anestésico en el local en el ligamento inguinal y, en cuatro pacientes, hubo necesidad de procedimiento quirúrgico en el tercer mes. El soporte neumático fue el menos involucrado en el desarrollo de la MP, así como el tiempo quirúrgico <1h e índice de masa corporal <25. Conclusión La MP refractaria puede ocurrir en pacientes sometidos a cirugías en la columna lumbar por vía posterior. El manejo incluye medidas locales, medicamentos para el dolor neuropático e infiltración con corticoide en el ligamento inguinal. La cirugía descompresiva está reservada para los raros casos refractarios. Nivel de evidencia III; Estudio prospectivo observacional con serie de casos comparativos.

Estimulación medular como tratamiento de la meralgia parestésica. ¿Es factible? Reporte de caso / Spinal cord stimulation to treat meralgia paresthetica. Is it feasible? A case report

La meralgia parestésica es un desorden neurológico causado por una neuropatía del nervio femorocutáneo lateral. Su etiología puede ser idiopática o iatrogénica. Se caracteriza por dolor, parestesias y entumecimiento en la cara anterolateral del muslo. Su diagnóstico es básicamente clínico, aunque pueden ser útiles pruebas de imagen o neurofisiológicas. A pesar de que el tratamiento conservador suele ser eficaz en la mayoría de los pacientes, existen casos refractarios que pueden precisar de otras formas de tratamiento. Los procedimientos quirúrgicos disponibles son la descompresión nerviosa (neurólisis) o la sección (neurectomía) y las ablaciones por radiofrecuencia. Presentamos un caso de meralgia parestésica invalidante refractaria en el cual empleamos la estimulación medular como posible técnica eficaz en el alivio del dolor y poder evitar la realización de una neurectomía del nervio femorocutáneo lateral (AU)

Meralgia paresthetica is a neurological disorder caused by a neuropathy of the lateral femoral cutaneous nerve. Its etiology can be spontaneous or iatrogenic. It is characterized by pain, paresthesia, and numbness in the anterolateral aspect of the thigh. Diagnosis is based on clinical examination, although image and neurophysiological tests can be useful as well. Despite conservative measures use to be effective in most of patients, refractory cases can benefit from alternative treatments. Available surgical procedures are: nerve decompression (neurolysis) or section (neurectomy) and radiofrequency ablation. We present a case of refractory meralgia paresthetica where spinal cord stimulation was used as a possible effective technique in pain relief and to avoid the neurectomy of the lateral femoral cutaneous nerve (AU)

Microanatomy of the lateral femoral cutaneous nerve in relation to inguinal ligament and its clinical importance / Microanatomia do nervo cutâneo femoral lateral em relação ao ligamento inguinal e sua importância clínica

BACKGROUND: A better knowledge of the composition and properties of connective tissue related to the Lateral Femoral Cutaneous Nerve (LFCN) and to the Inguinal Ligament may be important to understand the diagnosis and treatment applicable to injuries such as meralgia paresthetica. OBJECTIVE: To determine the relative amounts of the non-fascicular components in the following areas: (i) proximal to the inguinal ligament [LFCN-1], (ii) deep to the inguinal ligament [LFCN-2], or (iii) distal to LFCN-2 [LFCN-3]. These amounts were discriminated as adipose [FAT] and non-adipose (connective) [NON-FAT] tissues. METHOD: Samples of LFCN-1, LFCN-2 and LFCN-3 from 21 human cadaveric samples were used. Paraffin sections of these structures were processed by Masson's trichrome stain for connective tissue. The number of fascicles was counted in each of these structures; FAT and NON-FAT areas were determined in the non-fascicular areas of the structures. RESULTS: There were more fascicles in LFCN-3 vs. LFCN-1 or LFCN-2; there was more NON-FAT vs. FAT in LFCN-2 vs. LFCN-1 and LFCN-3; inversely, there was more FAT vs. NON-FAT in LFCN-3 vs. LFCN-1 and LFCN-2. All of these comparisons were statistically significant. CONCLUSION: The presence of a higher content of NON-FAT in LFCN-2 and FAT in LFCN-3 may help to explain meralgia paresthetica resulting from compression or focal entrapment of the Lateral Femoral Cutaneous Nerve as it passes deep relative to the inguinal ligament.

TEMA: Um melhor conhecimento da composição e propriedades do tecido conjuntivo relacionadas ao Nervo Cutâneo Femoral Lateral (NCFL) e ao Ligamento Inguinal pode ser importante para compreender o diagnóstico e o tratamento aplicável a lesões como a meralgia parestética. OBJETIVO: Determinar as quantidades relativas dos componentes não-fasciculares nas seguintes áreas: (i) proximal ao ligamento inguinal [NCFL-1], (ii) em profundidade ao ligamento inguinal [NCFL-2], ou (iii) distal a NCFL-2 [NCFL-3]. Esses valores foram discriminados como tecido conjuntivo adiposo [FAT] ou não-adiposo [NON_FAT]. MÉTODO: Foram utilizadas amostras de NCFL-1, NCFL-2 e NCFL-3 a partir de 21 amostras de cadáveres humanos. As secções em parafina destas estruturas foram processadas por coloração Masson para tecido conjuntivo. O número de fascículos foi contado em cada uma destas estruturas; áreas de gordura e sem gordura foram determinadas nas áreas não-fasciculares das estruturas. RESULTADOS: Foram contados mais fascículos em NCFL-3 vs. NCFL-1 ou NCFL-2; havia mais NON-FAT vs. FAT em NCFL-2 vs. NCFL-1 e NCFL-3; inversamente, houve mais FAT vs. NON-FAT em NCFL-3 vs. NCFL-1 e NCFL-2. Todas estas comparações foram estatisticamente significativas. CONCLUSÃO: A presença de um maior teor de NONFAT em NCFL-2 e FAT em NCFL-3 pode ajudar a explicar o aparecimento de paresthetica meralgia resultante da compressão ou encarceramento focal do Nervo Cutâneo Femoral Lateral que passa profundamente ao ligamento inguinal.

Utilidad de la neurografía por IRM en el diagnóstico de la meralgia parestésica / Usefulness of MRI neurography in the diagnosis of meralgia paresthetica

Objetivo: Evidenciar cómo la Imagen Resonancia magnética (IRM) con equipo de 3 Tesla, utilizando secuencias neurográficas específicas y uso de contraste endovenoso permite ubicar el área de lesión nerviosa. Caso clínico: Mujer de 17 años con hipoestesia y parestesias en la región anterior y lateral del muslo izquierdo, se le realiza un estudio de Resonancia Magnética (RM) en equipo Philips Achieva 3 T, usando protocolo neurográfico y contraste endovenoso, demostrando engrosamiento y cambios de señal del nervio y realce post-contraste característico de la neuropraxia. Conclusión: el caso presentado demuestra el valor actual de los estudios de IRM con técnica neurográfica en la evaluación de la patología de los nervios periféricos. Es fundamental utilizar secuencias adecuadas, realizar un estudio comparativo bilateral y en lo posible usar medios de contraste endovenoso para aumentar la sensibilidad. Estos hallazgos resultan de gran importancia a la hora de planificar la estrategia quirúrgica.

Objective: Demonstrate the usefulness of Magnetic Resonance Imaging (MRI) with equipment 3 Tesla using neurographics specific sequences and use of intravenous contrast can locate the area of nerve injury.Clinical case: 17 year old woman with hypoesthesia and paresthesia in the anterior and lateral region of the left thigh, the study of Magnetic Resonance Imaging (MRI) equipment Philips Achieva 3 T, using neurographic protocol and intravenous contrast, showing thickening and changes signal nerve and post-contrast enhancement characteristic in neuropraxia.Conclusión: the case presented shows the current value of MRI studies with neurographics technique in assessing the pathology of peripheral nerves. It is essential to use appropriate sequences, make a bilateral comparative study and possible use of intravenous contrast media to increase sensitivity. These findings are of great importance when planning the surgical strategy.