Multifactorial Determinants of Pulsed Radiofrequency Treatment Outcomes in Meralgia Paresthetica: A Focus on Obesity, Comorbidities, and Technical Variables.

BACKGROUND

Meralgia paresthetica (MP) is the second most common nerve entrapment.

AIMS: This study aimed to investigate the impact of obesity, comorbidities, and technical variables on treatment outcomes following ultrasound-guided pulsed radiofrequency (PRF) neuromodulation of the lateral femoral cutaneous nerve (LFCN) in MP over a 6-month period.

SETTING AND

METHODS

In this retrospective cohort study, 30 MP patients who underwent PRF of the LFCN and were followed for at least 6 months were analyzed. Treatment response was defined as a Douleur Neuropathique 4 (DN4) score <4 at 6 months. Obesity was classified as a body mass index (BMI) ≥30.

RESULTS

Of the patients, 13 (43.3%) were classified as responders (Group 1), while 17 (56.7%) were nonresponders (Group 2). Correlation analysis revealed that female sex (r = 0.372, P = 0.043), BMI (r = 0.582, P = 0.001), waist circumference (r = 0.411, P = 0.024), hip circumference (r = 0.557, P = 0.001), fibromyalgia (r = 0.458, P = 0.011), depression (r = 0.449, P = 0.013), high triglyceride (r = 0.447, P = 0.021) and total cholesterol levels (r = 0.401, P = 0.028), low vitamin D levels (r = -0.419, P = 0.021), shorter PRF duration (r = -0.833, P = 0.001), and inadequate response to the diagnostic block (r = 0.682, P = 0.001) were significantly associated with higher DN4 scores at 6 months.

CONCLUSIONS

Obesity was associated with decreased treatment success at 6 months post-PRF. Additionally, female sex, depression, fibromyalgia, vitamin D deficiency, and reduced cortical amplitude on the affected side negatively impacted outcomes. Longer PRF duration and greater response to the diagnostic block were linked to improved efficacy.