Abstract:
The prevalence of meralgia paresthetica (MP), which is caused by compression of the lateral femoral cutaneous nerve (LFCN), has been increasing over recent decades. Since guidelines and large-scale studies are lacking, there are substantial regional differences in diagnostics and management in MP care. Our study aims to report on current diagnostic and therapeutic strategies as well as time trends in clinical MP management in Germany. Patients hospitalized in Germany between January 1, 2005, and December 31, 2018, with MP as their primary diagnosis were identified using the International Classification of Disease (ICD-10) code G57.1 and standardized operations and procedures codes (OPS). A total of 5828 patients with MP were included. The rate of imaging studies increased from 44% in 2005 to 79% in 2018 (p < 0.001) and that of non-imaging diagnostic studies from 70 to 93% (p < 0.001). Among non-imaging diagnostics, the rates of evoked potentials and neurography increased from 20%/16% in 2005 to 36%/23% in 2018 (p < 0.001, respectively). Rates of surgical procedures for MP decreased from 53 to 37% (p < 0.001), while rates of non-surgical procedures increased from 23 to 30% (p < 0.001). The most frequent surgical interventions were decompressive procedures at a mean annual rate of 29% (± 5) throughout the study period, compared to a mean annual rate of 5% (± 2) for nerve transection procedures. Between 2005 and 2018, in-hospital MP care in Germany underwent significant changes. The rates of imaging, evoked potentials, neurography, and non-surgical management increased. The decompression of the LFCN was substantially more frequent than that of the LFCN transection, yet both types of intervention showed a substantial decrease in in-hospital prevalence over time.
摘要:
痛觉异常(MP)的患病率,这是由股外侧皮神经(LFCN)的压迫引起的,近几十年来一直在增加。由于缺乏指南和大规模研究,MP治疗的诊断和管理存在显著的地区差异.我们的研究旨在报告德国临床MP管理的当前诊断和治疗策略以及时间趋势。2005年1月1日至2018年12月31日在德国住院的患者,以MP为主要诊断,使用国际疾病分类(ICD-10)代码G57.1和标准化操作和程序代码(OPS)进行鉴定。共纳入5828例MP患者。影像学研究的比率从2005年的44%增加到2018年的79%(p<0.001),非影像学诊断研究的比率从70%增加到93%(p<0.001)。在非影像学诊断中,诱发电位和神经造影的比率从2005年的20%/16%上升至2018年的36%/23%(分别为p<0.001).MP的手术率从53%降至37%(p<0.001),而非手术率从23%增加到30%(p<0.001)。在整个研究期间,最常见的手术干预措施是减压手术,平均年发生率为29%(±5)。与神经横切手术的平均年率5%(±2)相比。在2005年至2018年期间,德国的医院MP护理发生了重大变化。成像率,诱发电位,神经造影术,非手术管理增加。LFCN的减压比LFCN横切更频繁,然而,两种类型的干预均显示,随着时间的推移,院内患病率显著下降.