Peripheral Nerve Surgery: A Medical Overview

Peripheral nerve surgery involves procedures to address issues with nerves outside the brain and spinal cord, including those in the arms, legs, hands, feet, and face. This surgery aims to restore nerve function, alleviate chronic pain, and reduce disability caused by nerve injuries or conditions, ultimately improving the patient’s quality of life. (1)

When is Peripheral Nerve Surgery Indicated?

Peripheral nerve surgery is considered when nerve damage does not adequately respond to traditional treatments like physical therapy or medication. Indications for surgery include: (2)

Acute Nerve Injuries: Such as those from accidents, fractures, or lacerations affecting peripheral nerves, leading to nerve transection or compression.
Nerve Tumors: Tumors growing on or around nerves, which may be benign or malignant, causing pressure on the nerve.
Neurological Disorders: Such as peripheral neuropathy, carpal tunnel syndrome, tarsal tunnel syndrome, and congenital nerve abnormalities.

Preparing for Peripheral Nerve Surgery

Preparation involves several key steps: (3)

Consultation: Meet with a neurosurgeon to review your medical history, symptoms, and discuss the surgical procedure, including risks and benefits.
Preoperative Instructions: Follow fasting instructions if required, complete necessary diagnostic tests and blood work, and quit smoking if applicable.
Medication Review: Inform your doctor about all medications and supplements you are taking; adjustments may be needed.

How is Peripheral Nerve Surgery Performed?

The surgical approach depends on the nature, location, and severity of the nerve issue. Procedures are conducted under general or local anesthesia and may include: (4)(5)

Nerve Decompression: Relieving pressure on nerves by expanding tight spaces or freeing nerves from constriction, as in carpal tunnel syndrome.
Nerve Repair or Grafting: Removing damaged parts of the nerve and reconnecting healthy ends, or using grafts from other body parts.
Tumor Removal: Surgically excising tumors affecting nerves.
Nerve Transplantation: Removing damaged nerve sections and transplanting nerve grafts from other areas of the body.

Postoperative Care

Recovery time varies, generally spanning from a few weeks to several months, depending on the surgery’s complexity. Postoperative care includes: (6)

Pain Management: Use prescribed pain relievers and antibiotics as directed.
Wound Care: Keep the wound clean and dry, and follow instructions for changing dressings. Stitches may be removed after 10-14 days or at home if directed.
Rehabilitation: Engage in physical therapy and follow rehabilitation protocols to regain function and strength.

Possible Side Effects

Post-surgery, you may experience: (6)

Swelling and Pain: Gradual reduction in discomfort over weeks.
Numbness: May persist for several weeks.
Weakness: Gradual improvement in the ability to move the affected area.
Bruising: At the surgery site.

Postoperative Instructions

Medications: Adhere to prescribed medications.
Physical Therapy: Attend all recommended sessions.
Wound Care: Avoid aggressive rubbing or scratching.
Activity Restrictions: Refrain from lifting heavy objects or repetitive movements for at least six weeks.

Complications

While generally safe, peripheral nerve surgery can have potential complications such as: (6)

Nerve Damage: Potential for increased weakness or numbness.
Symptom Recurrence: Possible return of original symptoms.
Joint Stiffness: In nearby joints.
Persistent Numbness: At the surgical site.
Tissue Damage: To surrounding tissues.

The Brain, Spine, and Nerve Surgery Department at the Saudi Hospital is equipped with advanced medical technology and staffed by leading neurosurgeons in the Middle East for precise and effective peripheral nerve surgery. References: