Vulnerability of the femoral nerve during complex anterior and posterior spinal surgery.
BACKGROUND
Femoral nerve palsy is not a common adverse effect of lumbar spinal surgery.


OBJECTIVE
To report 3 unique cases of femoral nerve neuropathy due to instrumentation and positioning during complex anterior and posterior spinal surgery.


METHODS
Case series


RESULTS
All 3 patients demonstrated femoral nerve neuropathy. The first patient presented postoperatively but after 6 months, the palsy resolved. Femoral nerve malfunctioning was documented in the second and third patients intraoperatively; however, with rapid patient repositioning and removal of offending instrumentation, postoperative palsy was avoided.


CONCLUSIONS
Use of motor evoked potential monitoring of the femoral nerve during surgery is vital for the prevention of future neuropathies, an avoidable complication of spinal surgery.
Department of Neurosurgery, Jefferson Medical College, Philadelphia, Pennsylvania 19107, USA.
Swetha
S
Naroji
Laurence J
LJ
Belin
Mitchell Gil
MG
Maltenfort
Alexander R
AR
Vaccaro
Daniel
D
Schwartz
James S
JS
Harrop
Michael
M
Weinstein
D005260:Female; D020428:Femoral Neuropathy / Q000209:etiology* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D013119:Spinal Cord Injuries / Q000601:surgery; D013123:Spinal Fusion / Q000009:adverse effects*; D055815:Young Adult