Treatment of meralgia paresthetica (Lateral Femoral Cutaneous Neuropathy): A meta-analysis of ultrasound-guided injection versus surgery

Purpose: To compare ultrasound (US)-guided injections and surgery for the treatment of meralgia paresthetica (lateral femoral cutaneous neuropathy). Methods: Two reviewers, independently, up to 10 October 2020 retrieved Studies that assessed the outcome of US-guided injections and surgery for the treatment of meralgia paresthetica from major medical libraries. Predefined inclusion and exclusion criteria were adopted. Results: 399 studies were initially found, and the meta-analysis was conducted on 10 studies for a total of 149 patients. US-guided injections were done in three studies, surgery in seven studies. N = 38 % (57/149) of patients were treated with US-guided injection and 62 % (92/149) were treated with surgery. After US-guided injections, 85 % (49/57) of patients were treated successfully, whereas 80 % (74/92) were treated with surgery successfully from the clinical point of view. Differences were not statistically significant even with a slight heterogeneity of studies and outcome pooled on random-effect model. No comparative cohort study or RCT was conducted. Conclusion: This meta-analysis showed that there was no statistically significant difference in treatment of meralgia paresthetica with ultrasound-guided injection or surgery. A RCT to compare a standardized US-guided approach versus surgery is essential to compare these techniques properly.