PERIPHERAL NERVE DECOMPRESSION
What is Peripheral Nerve Decompression?
The medical term ‘Peripheral nerve decompression’ refers to a surgical procedure intended to relieve pressure on one or more compressed or entrapped nerves. This surgical procedure typically occurs to provide relief from symptoms that develop with peripheral neuropathy.
Peripheral neuropathy refers to the damage or destruction of one or more nerves located outside of the brain and spinal cord. This condition often shows up with symptoms such as pain, numbness, burning or tingling sensations, and muscle weakness in the affected area. It usually takes place in the hands and feet of patients, but can also affect other parts of the body. Peripheral neuropathy largely indicates a problem within the peripheral nervous system and mostly occurs in patients with diabetes.
What are the Causes of Peripheral Neuropathy?
Peripheral neuropathy can result from several health conditions. The leading cause of peripheral neuropathy in the United States remains diabetes. Diabetes occurs as the most common cause of small fiber neuropathy, a medical condition that develops with painful or burning sensations in the hands and feet. Other health conditions that may cause peripheral neuropathy include Autoimmune disorders and infections, kidney and liver disorders, hyperthyroidism, benign tumors, vascular disorders, and compression of nerves due to repetitive stress, fractures, or trauma.
What are the Conditions for Peripheral Nerve Decompression?
Neurologists may recommend certain diagnostic tests to determine if the damaged nerves will heal properly without surgical intervention Peripheral nerve decompression surgeries usually occur for patients who have failed to respond positively to non-surgical treatments of nerve compression. A neurologist may recommend peripheral nerve decompression to relieve symptoms of medical conditions such as:
2- Ulnar nerve compression, which affects nerves in the arm
3- Peroneal nerve compression, which affects the knee
4- Meralgia paresthetica, a condition caused by compression of nerves in the upper leg
5- Tarsal tunnel syndrome, a condition caused by damage to the tibial nerve found near the ankle
6- Spinal accessory nerve injuries
7- Nerve injuries caused by trauma
8- Nerve tumors such as schwannomas and neurofibromas, especially those caused by genetic disorders
How do Neurosurgeons carry out Peripheral Nerve Decompression?
A Neurologist with the help of an orthopedic surgeon will typically begin peripheral nerve decompression surgery by identifying the entrapped nerve through an incision on the affected area. The surgeon will then release the tissues, vessels, or tight fascial bands responsible for the compression. This immediately provides relief from symptoms of nerve compression and allows for a more normal nerve function and regeneration.
Peripheral nerve decompression surgery may fail to reverse the symptoms of nerve entrapment in the case of severe nerve damage.
Callaghan, B. C., Gallagher, G., Freedman, V., & Feldman, E. L. (2020). Diabetic neuropathy: what does the future hold? Diabetologia, 63(5), 891–897. https://doi.org/10.1007/s00125-020-05085-9
Gerritsen AAM, de Vet HCW, Scholten RJPM, Bertelsmann FW, de Krom MCTFM, Bouter LM. Splinting vs. surgery in the treatment of carpal tunnel syndrome: a randomized controlled trial. JAMA. 2002 Sep 11;288(10):1245–51.
Mondelli M, Grippo A, Mariani M, Baldasseroni A, Ansuini R, Ballerini M, Bandinelli C, Graziani M, Luongo F, Mancini R, Manescalchi P, Pellegrini S, Sgarrella C, Giannini F. Carpal tunnel syndrome and ulnar neuropathy at the elbow in floor cleaners. Neurophysiol Clin Clin Neurophysiol. 2006 Aug;36(4):245–53.
Temiz Ç, Yaşar S, Kırık A. Surgical treatment of peripheral nerve injuries: Better outcomes with intraoperative NAP recordings. Ulus Travma Acil cerrahi Derg. 2021 Sep;27(5):510-515. English. doi: 10.14744/tjtes.2020.95702. PMID: 34476797.
Thomas M, Hinton A, Heywood A, Shirley R, Chan JKK. Peripheral nerve decompression in the upper limb in spinal cord injury: experiences at the National Spinal Injuries Centre, UK. Spinal Cord Ser Cases. 2021 Jul 7;7(1):56. doi: 10.1038/s41394-021-00423-4. Erratum in: Spinal Cord Ser Cases. 2022 Jan 13;8(1):4. PMID: 34234101; PMCID: PMC8263712.