Case Diagnosis: Obturator Nerve Entrapment
Case Description: This is a 29-year-old male presented with chronic left groin pain. Multiple injections , maximized dose of medications and procedures over the years have failed to alleviate his pain. He continued to complain of burning/sharp pain in his groin. We therefore attempted obturator nerve stimulator to treat his refractory groin/medial thigh pain.
Discussions: Peripheral nerve stimulation (PNS) is a useful treatment for chronic pain. This case report describes the first participant treated with a PNS for refractory groin/medial thigh pain. Medial thigh pain and groin pain are often difficult to diagnose due to the various structures that are passing through the region. One not commonly identified cause for groin and/or lower extremity pain is obturator nerve (ON) entrapment. Previous studies reported that the obturator nerve is one of the nerve that provides innervation to the anterior hip capsule.
The PNS was implanted using a complement of fluoroscopic and ultrasound guidance in the obturator canal. Fluoroscopic guidance was used to identify the previously described radiographic “teardrop” to localized ON. Ultrasound guidance was used in diving below major vasculature in the groin as the PNS is threaded to the obturator canal.
This case report demonstrates the feasibility of a single-lead, implantable PNS system through a single ~1 cm incision for refractory groin pain secondary to ON entrapment.