Peripheral Nerve Surgery

Peripheral nerves are responsible for sending messages, including pain, touch, hot, cold, etc., to the central nervous system in the brain and spinal cord. 

In addition, these nerves are also responsible for the controlling and movement of our muscles, and the performance of voluntary actions such as writing, talking, playing sports, etc., would not be possible without these nerves.

The ability to sense might get lost or altered when the peripheral nerve gets damaged. The altered sensation and the severity of the injury depend on the nerves or nerves that are damaged, the type, and the location of the injury. It is necessary to perform a surgical procedure if the patient wishes to recover fully from the medical condition. 

Peripheral nervous system problems disrupt signal transmission and decrease motor and sensory nerve activities.

What is a peripheral nerve injury?

All the nerves present in the human body except for the brain and spinal cord are a part of the peripheral nervous system. It consists of all the nerves in our arms, legs, chest, face, and abdomen. 

When these nerves face damage for any reason, such as a sports injury or another medical condition, the damage may lead to chronic pain that is difficult to diagnose & treat. This type of damage is known as peripheral nerve injury. 

Peripheral nerve damage can develop from trauma, surgery, or illnesses like diabetic neuropathy, which produces excruciating persistent pain that is challenging to identify and manage.

Peripheral Nerve Surgery entails using appropriate surgical care to alleviate pain brought on by nerve damage and compression. Surgery becomes inevitable when the medical condition becomes the reason for chronic pain.

Symptoms:

Damage to Peripheral nerves often results in limiting activities. Moreover, symptoms vary as per the damaged nerve/nerves, type, location, and severity of the injury. Given below is a list of nerves and their symptoms:

1. Sensory nerves: These nerves transmit information regarding pain, temperature, & touch to your brain. And you may feel a number of symptoms if one of these nerves suffers damage. 

Symptoms include tingling/numbers in the feet or hands. You may also feel trouble sensing pain, changes in temperature, difficulty walking, and problems in balancing your body when your eyes are closed.

1. Motor nerves: The role of motor nerves is to regulate all the muscles, such as the ones that are used for walking, playing, grasping things, etc., under your conscious control. 

When one of the motor nerves gets damaged, you may face symptoms like muscle weakness, painful cramps, difficulty performing certain routine tasks, grasping objects, and uncontrollable muscle twitching. 

1. Autonomic nerves: This group of nerves is responsible for regulating activities that are done unconsciously, such as breathing, digestion, blood circulation, etc. 

An injury to one of these nerves might result in symptoms like excess sweating, frequent blood pressure changes, difficulty tolerating heat, etc. 

Common peripheral nerve problems:

• Carpal tunnel syndrome: Carpal tunnel syndrome is a medical condition that occurs when excess pressure is exerted on the median nerve. Symptoms such as numbness, weakness, tingling, etc., can be felt when the median nerve is compressed. 

• Peroneal nerve injury: The peroneal nerve is responsible for all the leg movement and sensation. You may face symptoms like numbness, excruciating pain, weakness in leg muscles, and a gait problem known as 'foot drop.' This medical condition can occur due to trauma or nerve compression caused by knee dislocation/fracture. 

• Peripheral nerve tumors: Growths that occur in and around the nerves are known as Peripheral nerve tumors. Such tumors can occur anywhere in our bodies. These nerves are responsible for all of our routine activities, and damage to these nerves might result in difficulty performing routine tasks. Symptoms include inflammation, a lump under the skin, numbness, pain, or tingling—the dizziness of reduced control over the balance of your body. 

• Neurofibromas: It is also yet another type of Peripheral Nerve Tumor that forms soft bumps on the surface or under the skin. It can be formed in any major or minor nerve present in our bodies. It most frequently occurs in the center of a nerve. The symptoms are identical to the symptoms of peripheral nerve tumors. 

Diagnosis:

The doctor would take a look at your past medical conditions and ask you if you had any accidents or surgeries in the past. After which, they will ask you about the symptoms you're facing. Following the discussion regarding symptoms are physical and neurological examinations. Furthermore, the doctor might suggest some diagnostic tests if your neurological examination represents any symptoms of nerve injury. 

Diagnostic tests include:

• EMG (electromyography): a thin needle electrode is inserted into the muscle to record the activity of the muscle at rest as well as in motion. Reduced muscle activity might indicate a nerve injury. 

• MRI (magnetic resonance imaging): Magnetic and radio waves are used to create detailed pictures of areas that are affected by nerve injury.

• Ultrasound: Similar to an MRI, high-frequency sound waves produce detailed images of areas affected by nerve injury. 

• Nerve conduction study: In this test, electrodes are placed at two parallel points in order to measure how well nerves conduct electric signals. 

Treatment: 

The chances of healing an injury are higher if the nerve is injured but not cut. On the other hand, injuries in which the nerve has been separated into two parts are difficult to treat, and complete recovery may not be possible. 

The treatment will completely depend on your injury's type, location, and severity.

Given below are two methods of treatment that can be chosen for the treatment of peripheral nerve injuries:

1. Non-surgical method: surgery might not be necessary if the healing process of your nerve goes smoothly and properly. Your doctor may ask you to restrict the movement of the affected area so that it gets enough time to heal and the healing process stays intact. 

Moreover, regular checkups are required to ensure your current condition and determine whether the nerve is healing properly. If the cause of your nerve injury is another medical condition, the doctor will treat that underlying condition. 

Doctors will provide you with antibiotics and painkillers to numb the excruciating pain. In addition to that, the doctor might even suggest that you enroll yourself in physiotherapy, which is essential to regain the lost potential and movement of the affected area.

1. Surgical method: This treatment method is only chosen when the damaged nerve does not heal properly with medicines & non-surgical methods of treatment. In certain cases, when a nerve settles inside a tight space or is squeezed by scarring, your doctor might enlarge the space or free the nerve from a scar with the help of surgery. 

Moreover, a case becomes more complex due to torn or completely damaged nerves. In such cases, the surgeon will remove the damaged portion of the nerve and reconnect the healthy ends of a nerve or replace it with a nerve by taking it from a comparatively less important body part. 

Though, you will require physiotherapy in both treatment methods to regain the lost movement and strength of the affected area.

Recovery: 

• Casts/splints: Devices such as casts or splints keep the affected body part immobilized until it recovers completely. Otherwise, the movement that takes place during the absence of these devices might slow down or stop the recovery process.

• Physiotherapy: Physical physiotherapy includes particular exercises and movements for the affected body parts, and performing those exercises & movements helps in regaining the lost movement, strength, & potential of the affected body part. 

• Electric simulator: Simulators help reactivate the muscles that were affected by the nerve injury while the nerve is recovering. Nevertheless, the only drawback of this recovery process is that it might not be effective for every patient. 

Why choose Cutis Hospital for Peripheral nerve surgery?

Cutis is committed to providing its patients with the highest-quality care. They do not have to solve everything on their own. Each patient has a coordinator assigned to them who is available to them and their families while they are under our care. 

They can answer any questions you or your family may have, help you through the surgical procedure, and link you with any additional providers you might need.

Complete knowledge

This group of nerves comprises all the nerves present in our body except the brain and spinal cord. Doctors at Cutis possess thorough knowledge regarding all the injuries and medical conditions that can occur in/around these nerves and have years of practical experience in treating them. 

Thorough diagnosis 

It is important to conduct a thorough diagnosis before opting for a particular treatment method, as there are different types of treatment for different injuries & medical conditions related to peripheral nerves. These experts conduct all diagnostic examinations to diagnose a medical condition and confirm the diagnosis. Based on the diagnosis, these doctors choose a treatment method that might be the most suitable one for the patient.

Maintenance & sanitation

All the machines and equipment used for the treatment are maintained and cleaned thoroughly after each use. It avoids the transmission of infections or viruses from one patient to another because of the equipment. Hazardous and infectious waste is cleared out of rooms and the hospital on a regular basis.