Peripheral Nerve Release Surgery

The peripheral nervous system consists of nerves, plexuses, and ganglia located away from the brain and spinal cord. These include nerves in the arms, legs, as well as in the facial, chest, and abdominal areas. Peripheral nerves can be damaged due to injuries or diseases, and this can be a source of chronic pain.

In medicine, peripheral nerve release surgery is known as open peripheral nerve neurolysis. The primary goal of this procedure is to free and relieve the peripheral nerve or its trunk from adhesions and other factors that compress the nerve, disrupting its blood flow and normal function.

 

Main Symptoms

The patient may experience pain in the innervation area of the nerve. Each nerve has a specific zone it innervates—an area where nerve impulses are active. If a nerve is damaged, various functions in the affected area may become impaired. Over time, this can lead to numbness and weakening of the muscle it innervates, resulting in atrophy.

Common complaints include compression of the median nerve in the carpal tunnel, causing pain and numbness in the hand, particularly in the first through third fingers. Symptoms affecting the fourth and fifth fingers are often due to compression of the ulnar nerve in the elbow canal, near the inner surface of the elbow. Similar symptoms may occur in the lower leg from compression of the peroneal nerve.

 

Consultation

To assess initial complaints and formulate a treatment plan, it is necessary to consult a neurologist or neurosurgeon. This helps determine if surgical treatment is required. During the consultation, doctors will evaluate symptom progression, the course of the condition, and its connection to other health factors.

Before the consultation, it is recommended to undergo ultrasound of the wrist or elbow canal. This examination assesses the canal width, degree of nerve compression (measured by nerve thickness), and potential causes of compression (such as thickened ligaments). Additionally, an electromyography (EMG) test may be necessary to evaluate the functional state of the nerve.

 

The operation

Once a joint decision to proceed with surgery has been made, the following tests are required:

• Complete blood count
• Biochemical blood test
• Blood clotting test

Patients can bring their test results on the day of surgery or have them conducted at the clinic.

The surgery is performed under local or general anesthesia, and sometimes a combination of both. The type of anesthesia is decided with the surgeon prior to the procedure.

The surgery itself takes about 30–40 minutes, and the patient can go home 3–4 hours later with an accompanying person.

 

Postoperative Care

In the postoperative period, the hand should remain at rest.

• Stitches are removed after 10–12 days, followed by outpatient rehabilitation.
• During the first month, it is advised not to lift more than 1 kg (2.2 lbs), and in the second month, not more than 2 kg (4.4 lbs).
• An individualized treatment and rehabilitation plan is developed during the consultation with the neurosurgeon.
• Individualus gydymo ir reabilitacijos planas sudaromas gydytojo neurochirurgo konsultacijos metu.

 

Important Reminder: It is essential to consult a neurologist or neurosurgeon to discuss treatment options for peripheral nerve conditions before proceeding with any surgical treatment.