peripheral nerve surgery in wrist

What Is Peripheral Nerve Surgery?

Peripheral nerve surgery most often involves the decompression or surgical repair of a nerve. Peripheral nerves are those nerves that originate and branch out from the spinal cord to serve other areas of the body such as the arms, legs or extremities. They include any nerve that is outside the brain or spinal cord (the central nervous system).

What Does Peripheral Nerve Surgery Treat?

Peripheral nerve surgery can treat nearly any area of the body and is not limited to the upper extremities. Some of the more common nerves that may require peripheral nerve surgery include:

  • Brachial plexus (shoulder and arm)
  • Median nerve (wrist and hand)
  • Posterior tibial nerve (lower leg)
  • Sciatic nerve (lower back, buttocks, leg)

Peripheral neuropathy is an umbrella term for problems with peripheral nerves. There are more than 100 types of peripheral neuropathy conditions.  Many of these are what are called compression neuropathies such as:

  • Carpal tunnel syndrome, which affects the wrist and hand
  • Cubital tunnel syndrome, which affects the elbow and hand
  • Tarsal tunnel syndrome, which affects the lower leg, ankle, and foot

Symptoms of peripheral neuropathy depend on the underlying cause and which nerves are affected, but in general can include:

  • Tingling sensation
  • Numbness or loss of sensation
  • Pain
  • Muscle weakness
  • Muscle atrophy
  • Changes in temperature sensation
  • Excessive sweating

Although many forms of neuropathy are treated without surgery, Dr. Jacobson can work with a specialized neurologist, an expert in non-surgical neuropathy treatment, to help diagnose and treat you.

What Types of Procedures Are Performed During Peripheral Nerve Surgery?

Peripheral nerve surgery can encompass a number of different types of procedures. A great many are decompression surgeries, which involve taking pressure off of a nerve, such as in the case of carpal tunnel or cubital tunnel release.

In a compression neuropathy, something is pressing on a nerve, squeezing it and possibly causing numbness or pain. Nerve compression can also block the transfer of electrical impulses to and from the central nervous system (the brain and spinal cord), which can lead to muscle weakness and atrophy. The goal of decompression surgery is to relieve that pressure.

Decompression surgery can be accomplished in a number of ways. Sometimes there is a structure that is pressing on the nerve that can be removed. In other cases, the nerve is passing through a narrow space that can be widened, like in carpal tunnel and cubital release surgery.

Some damaged nerves can be repaired. This involves surgically removing damaged tissue or scar tissue from the nerve. Sometimes the nerve needs to be reattached to the area it serves. If reattachment is impossible due to short length, nerves from elsewhere in the body can be grafted onto the damaged nerve.

Sometimes a nerve is severely damaged, preventing it from transferring signals to or receiving signals from the central nervous system. In such situations, a nerve transfer can be a viable option. During a nerve transfer, the surgeon moves nerves that are close to the target area but are less important so that they can take over the function of the damaged nerve, restoring movement or sensation or even relieving pain.

What Types of Doctors Perform Peripheral Nerve Surgery?

Plastic surgeons are experts in peripheral nerve surgery and specialize in working with soft tissue in many parts of the body.  Although some neurosurgeons and orthopedic surgeons also perform peripheral nerve surgery, many patients are surprised to learn that peripheral nerve surgery is primarily a specialty of plastic surgeons.

If you need a peripheral nerve specialist, Dr. Jacobson may be able to help. Contact us today to discuss your treatment options.