Lateral Femoral Cutaneous Nerve

  • Cutaneous innervation of the lateral thigh
  • Dorsal branch of L2 and L3 (may be anatomical variants)
  • Passes under inguinal ligament 
  • 2 cm medial to ASIS
  • Superficial to sartorius and divides below sartorius muscle into anterior and posterior branches
  • Nerve is superficial to Iliacus muscle and between the Facia Iliaca and Fascial Lata
  • Often found distal to inguinal ligament lateral to sartorius muscle  in fat pad 

Meralgia Paresthetica

  • Mononeuropathy of the lateral femoral cutaneous nerve
  • Can lead to significant disability when the diagnosis and treatment is delayed or missed
  • Dysesthesia or anesthesia in the distribution of the LFCN. 
  • Patients typically describe burning, coldness, lightning pain, deep muscle achiness, tingling, frank anesthesia, or local hair loss in the anterolateral thigh.

Lateral Femoral Cutaneous Nerve

  • Primarily a sensory nerve but also includes efferent sympathetic fibers carrying vasomotor, pilomotor, and sudomotor impulse
  • Variable but L2 and L3, L1 and L2, L2 alone, and L3 alone.
  • Associated with the femoral nerve as it passes through the inguinal ligament or may anastomose with the femoral nerve distal to the inguinal ligament
  • On occasion, the LFCN is absent and may be replaced by a branch of the ilioinguinal nerve
  • Frequently found passing through the split lateral attachment of the inguinal ligament. 
  • As the nerve curves medially and inferiorly around the anterior superior iliac spine, it may be subjected to repetitive trauma in this fibroosseous tunnel

Lateral Cutaneous Femoral Nerve Block Indications

A frequently used method to induce cutaneous anesthesia or analgesia to the anterolateral side of the thigh.

  • skin grafting

  • muscle biopsy

  • meralgia paresthetica

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