ORIGINAL RESEARCH
J. Abdom. Wall Surg.
Redo-Posterior Neurectomy or Conservative Treatment for Recurrent Pain After Posterior Neurectomy in Anterior Cutaneous Nerve Entrapment Syndrome – A Case Comparison Analysis
- TT
Tom ten Have 1,2,3
- MR
Marc R.M. Scheltinga 1,2
- EB
Elise Bekers 4
- WA
Willem A.R. Zwaans 1,2,3
- RM
Rudi M.H. Roumen 1,2
1. Department of Surgery, Máxima Medical Center, Veldhoven, Netherlands
2. SolviMáx, Center of Expertise for Complex Groin and Abdominal Wall Pathology – Máxima Medical Center, Eindhoven, Netherlands
3. NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, Netherlands
4. Department of Pathology, Clinical Diagnostics PAMM, Veldhoven, Netherlands
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Abstract
Objective To provide insight into treatment outcomes of a redo-posterior neurectomy compared to conservative treatments in ACNES patients with recurrent pain after a previous successful posterior neurectomy. Summary background data Most patients with chronic abdominal pain due to anterior cutaneous nerve entrapment syndrome (ACNES) benefit from a step-up treatment regimen including abdominal wall injections, pulsed radiofrequency, or surgery (an anterior or posterior neurectomy). However, some 20% of patients who underwent an initially successful posterior neurectomy develop recurrent pain. To date, studies regarding treatment options and outcomes of these patients are scarce. Methods Eligible patients who received treatment in our center of expertise between January 2012 and February 2023 were analyzed using a questionnaire. Success was defined as a minimal 50% pain reduction for at least 3 months postoperatively using pain scores and Patient Global Impression of Change (PGIC). Results Of 57 eligible patients, 37 (76% female, mean age 39 years) completed the questionnaire (65% response rate). Twenty had undergone a redo-posterior neurectomy whereas the remaining 17 patients continued conservative measures. Short-term surgical success rate was 95%. In the long-term (median 40 months), surgical treatment outcome was more successful compared to a conservative treatment regarding pain reduction (85% vs. 41%; p=0.008) and PGIC (70% vs. 41%; p=0.018). Conclusion Based on the current study, redo-posterior neurectomy may be considered a beneficial option for ACNES patients with recurrent pain after an initially successful posterior neurectomy.
Summary
Keywords
Abdominal pain, chronic abdominal wall pain, acnes, neurectomy, Surgery
Received
28 April 2025
Accepted
05 December 2025
Copyright
© 2025 ten Have, Scheltinga, Bekers, Zwaans and Roumen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Tom ten Have, tom.ten.have@mmc.nl
Disclaimer
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.