12 Oct PERIPHERAL NERVE RELEASE SURGERY
The peripheral nervous system consists of nerves, nerve plexuses, and nodes that are distal to the brain and spinal cord. These are nerves in the arms and legs, face, chest, and abdomen. The peripheral nerve can be damaged by a variety of reasons – injury or illness. However, it can also cause chronic pain.
In medicine, peripheral nerve release surgery is called open peripheral nerve neurolysis. The main purpose of this surgery is to release the peripheral nerve or its plexus from adhesions and other causes that compress the nerve, disturb blood circulation and normal function.
A person feels pain in the area of innervation. Each nerve has its own innervation area, where the nerve transmitting impulses work. When this area is injured, its functions are disrupted. In time some symptoms, such as numbness, a decrease of muscle function. This may lead to muscle contraction and atrophy.
Most people complain of compressed middle nerve in the carpal tunnel that causes pain and numbness in the hands, especially the first to third fingers. The same symptoms of the fourth to fifth fingers are caused by a compressed ulnar nerve in the elbow canal, the inner surface of the elbow. Similar symptoms may be felt in the shin due to the compressed sciatic nerve.
To evaluate initial complaints and to create a treatment plan the consultation of a neurologist and / or neurosurgeon is needed in order to evaluate if the surgical intervention is necessary. During the consultation, doctors will examine the progression of the symptoms, the condition of the disease and the connection with other conditions of the body.
Before the consultation, we recommend an ultrasound examination of the carpal or elbow canal. The examination is needed to assess the area of the canal and the degree of compression of the nerve (measured in thickness) and the possible cause of compression (tightening of the ligaments). In addition, electroneuromyographic (ENMG) examination is required for functional evaluation of the nerve.
When a patient and a doctor decide that surgery is necessary the following tests are required:
- general blood test;
- biochemical blood test;
- blood coagulation tests.
Patients can bring their test results before the surgery or it can be done the same day at our clinic.
The surgery is performed in local anesthesia or in general anesthesia. Before the surgery, this decision is made with the neurosurgeon who treats the patient.
The duration of the surgery itself is about 30 – 40 minutes. And after 3-4 hours the patient may go home with an accompanying person.
THE POSTOPERATIVE PERIOD
During the postoperative period, the patient needs to rest the hand.
The suture is removed after 10 to 12 days after the surgery and then rehabilitation is needed.
We recommend to not lift more than 1 kg in the first month and 2 kg or more in the second month.
The sick leave depends on the patient’s job.
An individual treatment and rehabilitation plan is made during a consultation with the neurosurgeon usually together with a physical therapist.
As a reminder, treatment options for peripheral nerve disorders must first be discussed with your neurologist or neurosurgeon.