REVIEW
O nervo cutâneo femoral lateral (NCFL) é um nervo exclusivamente sensitivo da face anterolateral da coxa e o substrato anatômico da meralgia parestésica, neuropatia compressiva que cursa com dor, parestesia e disestesia nesse território. Dada sua vulnerabilidade à compressão e à lesão iatrogênica, o conhecimento anatômico detalhado é essencial para cirurgiões, anestesiologistas e neurologistas. Esta revisão narrativa sintetiza dados cadavéricos, cirúrgicos e de imagem sobre sua origem, trajeto e relevância clínica. O nervo origina-se habitualmente das divisões dorsais dos ramos ventrais de L2–L3, emerge na borda lateral do psoas maior, cruza obliquamente o ilíaco no retroperitônio e alcança a região inguinal medialmente à espinha ilíaca anterossuperior (EIAS), onde a compressão é mais provável. A variabilidade é a regra: origem, saída pélvica, relação com a EIAS e o ligamento inguinal (tipos A–E de Aszmann), ramificação e território cutâneo variam amplamente, com variantes em até 25% dos indivíduos. Delimitamos a “zona de perigo” cirúrgica ao redor da EIAS, relevante para herniorrafia inguinal, enxerto ósseo ilíaco, abdominoplastia e artroplastia total do quadril por via anterior direta, além das implicações para bloqueios guiados por ultrassom e cirurgia descompressiva. Reconhecer essa variabilidade previne lesões e orienta o manejo da meralgia parestésica.
The lateral femoral cutaneous nerve (LFCN) is a purely sensory nerve supplying the anterolateral thigh and the anatomical substrate of meralgia paresthetica, a compressive neuropathy causing pain, paresthesia and dysesthesia in that territory. Because of its vulnerability to compression and iatrogenic injury, detailed anatomical knowledge is essential for surgeons, anesthesiologists and neurologists. This narrative review synthesizes cadaveric, surgical and imaging data on its origin, course and clinical relevance. The nerve usually arises from the dorsal divisions of the L2–L3 ventral rami, emerges at the lateral border of psoas major, runs obliquely over the iliacus in the retroperitoneum, and crosses the inguinal region medial to the anterior superior iliac spine (ASIS), where compression is most likely. Variability is the rule: origin, pelvic exit, relationship to the ASIS and inguinal ligament (Aszmann types A–E), branching pattern and cutaneous territory all differ, with variants reported in up to 25% of individuals. We define the surgical “danger zone” around the ASIS relevant to inguinal herniorrhaphy, iliac bone-graft harvesting, abdominoplasty and direct anterior total hip arthroplasty, and discuss implications for ultrasound-guided blocks and decompression surgery. Recognizing this variability underpins injury prevention and accurate management of meralgia paresthetica.
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1Faculty of Medicine, Universidade Federal do Triângulo Mineiro, Uberaba, MG, Brazil.
2Neurosurgery Division, Universidade Federal do Sergipe, Aracaju, SE, Brazil.
Received Jun 1, 2026
Accepted Jun 25, 2026
