• J Spinal Cord Med · Jan 2009

    Case Reports

    Vulnerability of the femoral nerve during complex anterior and posterior spinal surgery.

    • Swetha Naroji, Mitchell Gil Maltenfort, Laurence J Belin, Alexander R Vaccaro, Daniel Schwartz, James S Harrop, and Michael Weinstein.
    • Department of Neurosurgery, Jefferson Medical College, Philadelphia, Pennsylvania 19107, USA.
    • J Spinal Cord Med. 2009 Jan 1; 32 (4): 432-5.

    BackgroundFemoral nerve palsy is not a common adverse effect of lumbar spinal surgery.ObjectiveTo report 3 unique cases of femoral nerve neuropathy due to instrumentation and positioning during complex anterior and posterior spinal surgery.MethodsCase seriesResultsAll 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.ConclusionsUse 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.

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