Samuel Goorman1, Iram Zaman2, Lonni Schultz2, Anza Memon3, Elizabeth Ho2
1Wayne State University, Henry Ford Hospital - Detroit, MI, 2Henry Ford Hospital, 3John D. Dingell, VAMC, Detroit, Michigan
Objective:
The primary objective of this research study is to gain understanding of electrophysiological findings and value of repeat EMG/NCS for prognostication in patients with obturator neuropathy.
Background:
Obturator neuropathy presents as an uncommon cause of lower extremity weakness with other symptoms including medial thigh numbness, weakness of thigh adduction, and lower extremity pain.
Design/Methods:
This single center retrospective study aimed to summarize various clinical features of obturator neuropathy. A total of 36 patients with obturator neuropathies diagnosed over a 20-year period, August 2002 to July 2022 were evaluated. Demographic, clinical, and electrographic data were collected, and descriptive statistics were used to analyze the variables of interest. The variables of interest included etiology, symptoms, physical exam signs, time to diagnosis from symptom onset, treatment, age, race, sex, insurance, prognosis, and electromyography (EMG) findings.
Results:
Of the 36 patients evaluated, surgery related trauma (n=21; 58%) was the most common etiology, and lower extremity pain (n=30; 86%) was the most common symptom. Based on diagnoses made through EMG, 23 patients (79%) had pure obturator neuropathy. Treatments led to improvement or complete resolution in 18 (50%) patients while 11 (31%) had no relief. No significant difference in time to diagnosis was observed based on sex, race, or insurance type.
Conclusions:
Obturator neuropathies are commonly associated with lower extremity weakness leading to difficulties in ambulation. Surgical trauma was the most common cause in our patient group, followed by cancer related causes. Electrodiagnostic findings, mainly EMG studies, aid in the definitive diagnosis. The lack of statistically significant differences between race, sex, or insurance in our patient group suggests an equitable process of evaluation of patient from their initial presentation with a provider to a definitive diagnosis. The lack of symptomatic improvement in 31% of patients in our group demonstrates the continued need for advancements in nerve repair and regrowth.