Success rates of a surgical neurectomy for lateral cutaneous nerve entrapment syndrome (LACNES)

Abstract Objectives Chronic flank pain is occasionally due to entrapped lateral end branches of intercostal nerves (lateral cutaneous nerve entrapment syndrome, LACNES). If local injection therapy fails, a neurectomy may be considered. The literature on LACNES is limited to case reports and a small case series. Aim of the present study is to determine short- and long-term success rates of a neurectomy in a large group of patients with LACNES. Methods All adult patients who underwent a neurectomy for LACNES between January 2012 and December 2022 in a single centre of expertise were asked to complete a questionnaire regarding their current pain levels. Primary objectives were short-term (6–12 weeks postoperatively) and long-term (>6 months postoperatively) treatment outcome. A successful outcome was defined as a minimal 50 % pain reduction. Results Data from 54 of 69 operated patients (81 % female, mean age 47 years) were analysed (78 % response rate). Baseline characteristics of responders and non-responders were not different. A 67 % short-term success rate was observed (n=36). Long-term outcome remained successful in 23 patients (43 %, mean follow-up 23 months). Ten patients had minor complications (delayed wound healing n=6, hematoma n=3, deep vein thrombosis n=1; all recovered after conservative treatment). Conclusions If local injection therapy fails in LACNES, a lateral neurectomy should be discussed. Approximately half of patients report success on the long-term. Trial registration The Local Medical Ethics Committee of Máxima Medical Centre number N20.125.