Functional recovery of severe obturator and femoral nerve injuries after lateral retroperitoneal transpsoas surgery

Case report

Amir Ahmadian M.D., Naomi Abel M.D., and Juan S. Uribe M.D.
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  • Department of Neurosurgery, University of South Florida, Tampa, Florida
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The minimally invasive lateral retroperitoneal transpsoas approach is a popular fusion technique. However, potential complications include injury to the lumbar plexus nerves, bowel, and vasculature, the most common of which are injuries to the lumbar plexus. The femoral nerve is particularly vulnerable because of its size and location; injury to the femoral nerve has significant clinical implications because of its extensive sensory and motor innervation of the lower extremities. The authors present an interesting case of a 49-year-old male patient in whom femoral and obturator nerve functional recovery unexpectedly occurred 364 days after the nerves had been injured during lateral retroperitoneal transpsoas surgery. Chronological video and electrodiagnostic findings demonstrate evidence of recovery. Classification and mechanisms of nerve injury and nerve regeneration are discussed.

Abbreviations used in this paper:

EMG = electromyography; LIF = lumbar interbody fusion; MIS = minimally invasive surgery; MRC = Medical Research Council; SASD = small-amplitude, short-duration.

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