Peripheral nerve surgery is a surgical process which is used for the treatment of chronic pain and peripheral nerve disorder such as nerve damage, nerve injury and nerve cancer. In this condition,the body continuously sends pain signals to the brain. Chronic pain also causesa burning and aching sensation in the affected area.
This process is performed under the general anesthesia but in some cases, local anesthesia and sedation are also used. Peripheral nerve surgery is done in two ways;
- Nerve grafting: in this technique surgeon will take a part of the nerve from a donor and attach it form the injured nerve.
- Nerve transfer: In this technique, a nearby working nerve is connected to the old and injured nerve.
- Brachial Plexus Injury: The brachial plexus is a network of a nerve which controls the movement and sensation of hand and arm through the spinal cord. The brachial plexus injury is caused when the nerve is stretched and compressed and there is sudden damage in nerve. The patient may experience loss of sensations, weakness in arms, hand, and shoulder.
- Carpal Tunnel Syndrome: It is a common condition which causes pain, tingling, and numbness in hand and arm. This condition is caused when the compression increases within the wrist on the major nerve of hand known as the median nerve.
- Cubital (Ulnar) Tunnel Syndrome: Cubital tunnel syndrome is caused when the ulnar nerve of hand is stretched, and compressed. The patient may experience numbness and tingling sensation. This condition may also cause pain and soreness.
- Schwannomas: It is a type of tissue cancer which develops on the nerve sheath. The schwannomas occur in a special type of cellsknown asSchwann cell.
- Neurofibromas: Neurofibromas are a type of nerve tumor which causes a soft bump under the skin. Neurofibromas may develop inmajor and minor nerves of the body.
If you have any of the above diseases or symptoms, you should consult with the neurologist in Gurgaon
Various tests are conducted by the neurosurgeon before performing the peripheral nerve surgery. It involves a detailed evaluation of the sensory and motor nerve functions. Sensation such as thermal sensation, tactile sensation, and pain are evaluated. The motor function evaluation includes grip strength and analyzing muscle strength and contraction.
Anesthetic agents such as bupivacaine are used along with the infusion pump to control post-operative pain. Proper drainage apparatus such as Jackson-Pratt drain is used to manage drainage after the operation.
The procedure of surgery depends upon the type of surgery recommended. The surgery may either be for nerve repair, nerve grafting or nerve transfer.
Nerve repair surgery can be performed when the distal and proximal end of a damaged nerve are close to each other and joining them does not cause any tension. If nerve repair has the risk of developing tension, other types of nerve surgeries can be advised.
In nerve grafting, the nerve of a donor is used to fill the gap between the proximal and distal end of the damaged nerve.
Another method is the nerve transfer in which a nearby non-critical nerve is used to fill the gap. The method is successful when either there is a large nerve gap or a proximal nerve injury or both.
The recovery of the patient after peripheral nerve surgery depends upon the type of nerve injury as well as the type of surgery done. A plaster cast is fitted after surgery to provide optimum relaxation to the nerve. The plaster cast may be revised 4-6 weeks after surgery, however, processes such as massage therapy, splinting, occupational therapy and psychological counseling should be continued. As soon as the power in the nerve is seen in the muscles related to repaired nerve, gentle exercise can be started.
To minimize the complications during peripheral nerve surgery, the patient should get the surgery done with the best neurologist in Gurgaon. Following are some of the complications of peripheral nerve surgery:
- Pulmonary complications: Pulmonary complications can be seen especially when the surgery is long and is under general anesthesia. The patient may experience pulmonary embolism, respiratory distress syndrome, and atelectasis.
- Post-operative hematoma: Excessive and releasable muscular dissection may lead to hematoma as this may create fistulae and bleeding points.
- New neurological defects: In some cases, New neurological effects may occur. This is most common in nerve surgeries involving removal of tumors.
- Risk of infection: As with other surgeries, peripheral nerve surgery also has the risk of infection especially when a larger area of tissues gets exposed.