Peripheral Nerve Surgery
What is Peripheral Nerve Surgery ?
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Why do you need Peripheral Nerve Surgery ?
Peripheral nerve surgery is indicated for:
- Nerve injuries:
- Traumatic: Lacerations, stretch injuries, or fractures (e.g., brachial plexus injury from accidents).
- Iatrogenic: Nerve damage during surgery (e.g., radial nerve injury during humerus fracture repair).
- Nerve entrapment syndromes:
- Carpal tunnel syndrome (median nerve compression at the wrist).
- Cubital tunnel syndrome (ulnar nerve compression at the elbow).
- Peroneal nerve entrapment (foot drop from compression at the knee).
- Peripheral nerve tumors:
- Benign: Schwannomas, neurofibromas (often linked to neurofibromatosis).
- Malignant: Rare, like malignant peripheral nerve sheath tumors (MPNSTs).
- Neuropathic pain: Post-traumatic or post-surgical nerve pain (e.g., neuroma formation).
- Chronic conditions: Nerve damage from diabetes, infections, or toxins causing weakness or sensory loss.
The procedure aims to relieve compression, repair nerve damage, remove tumors, or manage pain, improving function and quality of life.
Why Do Peripheral Nerve Surgery Costs Vary in Philippines?
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Peripheral Nerve Surgery Procedure
- Before Surgery Evaluation:
- Diagnosis:
- Electromyography (EMG) and nerve conduction studies (NCS): Confirm nerve injury, location, and severity.
- MRI or ultrasound: Visualizes nerve tumors, neuromas, or entrapment sites.
- Clinical exam: Assesses motor (e.g., weakness) and sensory deficits (e.g., numbness, tingling).
- Blood tests: Rule out systemic causes (e.g., diabetes, vitamin B12 deficiency).
- Medications: Pain relief (e.g., gabapentin for neuropathic pain); anti-inflammatories for entrapment.
- Consent: Risks, including incomplete recovery, are explained.
- Diagnosis:
- Surgical Techniques:
- Nerve Decompression:
- Carpal Tunnel Release:
- Performed under local anesthesia, lasting 15–30 minutes.
- A 2–3 cm incision is made at the wrist.
- The transverse carpal ligament is cut to relieve median nerve compression.
- The incision is closed with sutures.
- Cubital Tunnel Release:
- A 3–5 cm incision at the elbow; the ulnar nerve is decompressed by releasing constricting tissues.
- Carpal Tunnel Release:
- Nerve Repair (Neurorrhaphy):
- For traumatic nerve cuts, lasting 1–3 hours.
- Under general anesthesia, the nerve ends are identified, cleaned, and sutured together (end-to-end repair) using microsurgery.
- If a gap exists, a nerve graft (e.g., from the sural nerve in the leg) bridges the defect.
- Nerve Tumor Resection:
- For schwannomas/neurofibromas, lasting 1–3 hours.
- A small incision over the tumor; the tumor is carefully dissected from the nerve using a microscope to preserve nerve function.
- Malignant tumors may require wider resection, sometimes sacrificing the nerve.
- Neurolysis:
- For scar tissue or adhesions around a nerve (e.g., post-trauma), the nerve is freed to restore function.
- Intraoperative Tools:
- Microscope: Enhances precision in nerve handling.
- Nerve stimulator: Confirms nerve function during surgery.
- EMG/NCS: Intraoperative monitoring to assess nerve response.
- Nerve Decompression:
- After Surgery:
- Ward monitoring for 1–2 days; hospital stay of 0–2 days (outpatient for decompression).
- Pain management: Analgesics (e.g., paracetamol) for 1–2 weeks.
- Splinting: Wrist splint (carpal tunnel, 1–2 weeks); arm/leg splint (nerve repair, 3–6 weeks) to protect the nerve.
- Physical therapy: Starts at 2–4 weeks to restore strength and mobility.
- Follow-up EMG/NCS: At 3–6 months to monitor nerve recovery.
Recovery After Peripheral Nerve Surgery
- Hospital Stay: 0–2 days (outpatient for decompression; 1–2 days for nerve repair/tumor resection).
- Post-Surgery Care:
- Pain: Incision discomfort for 1–2 weeks; neuropathic pain may improve over months.
- Activity: Light use of the limb immediately (decompression); restricted movement for 3–6 weeks (nerve repair).
- Splinting: Protects the nerve during healing (e.g., wrist splint for carpal tunnel).
- Physical therapy: Starts at 2–4 weeks; focuses on range of motion, strength, and desensitization (if numbness persists).
- Sensation/motor recovery: Slow (1 mm/day nerve regeneration); may take 3–12 months depending on injury severity and distance to target muscle.
- Diet: Normal diet; high-protein foods (e.g., eggs, lentils) support healing; 2–3 liters water daily.
- Follow-Up:
- Visits at 2 weeks, 6 weeks, and 3–6 months; EMG/NCS at 3–6 months.
- Monitor for functional improvement (e.g., grip strength, sensation).
Recovery varies: Decompression (e.g., carpal tunnel) sees 80–90% symptom relief in 6–12 weeks; nerve repair recovery takes 6–12 months, with 60–80% functional recovery depending on injury severity. Tumor resection success: 90% for benign tumors with preserved nerve function.
Risks and Complications
- Surgical Risks: Bleeding (1–2%), infection (1–3%), scar tenderness (2–5%).
- Neurological Complications:
- Incomplete recovery (10–30% in nerve repair): Due to delayed surgery, long gaps, or severe damage.
- Worsening symptoms (1–3%): Temporary or permanent numbness/weakness.
- Neuroma formation (2–5%): Painful nerve scarring, may require further surgery.
- Tumor-Specific: Recurrence (5–10% for benign tumors; higher for malignant); nerve sacrifice (malignant, 10–20%).
- General Risks: Anesthesia reactions, delayed wound healing.
- Long-Term: Chronic pain (2–5%), limited functional recovery (esp. in older patients or delayed repairs).
Report fever, severe pain, or worsening symptoms promptly.
Frequently Asked Questions (FAQs)
What causes peripheral nerve issues?
Trauma, repetitive strain (e.g., carpal tunnel), tumors, diabetes, or iatrogenic injury (surgery-related).
Can nerve damage heal without surgery?
Mild entrapments may improve with rest, physiotherapy, or injections (e.g., 50–70% of carpal tunnel cases); severe injuries or tumors often require surgery.
Will I regain full function?
Decompression: 80–90% success; nerve repair: 60–80% recovery, depending on timing and injury severity.
How soon can I resume activities?
Decompression: 2–4 weeks; nerve repair: 6–12 weeks for light activities, full recovery in 6–12 months.
Is peripheral nerve surgery covered by insurance in India?
Yes, for symptomatic conditions; confirm with your provider.
Signs of complications?
Fever, severe pain, swelling, or worsening numbness/weakness.
Can nerve damage recur?
Yes, entrapment can recur (5–10%) if risk factors (e.g., repetitive strain) persist; tumors may recur (5–10%).
Lifestyle changes post-surgery?
Avoid repetitive strain, use splints as advised, continue physiotherapy, and follow up regularly.
Conclusion
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Looking for Best Hospitals for Peripheral Nerve Surgery
Note: we are not promoting any hospitals
We do not promote any hospitals. All details are sourced from Google and hospital websites. Please verify independently. Start with your surgery—here’s the list of government, budget, and superspecialty hospitals accredited by the Department of Health (DOH), Philippine Health Insurance Corporation (PhilHealth), and Joint Commission International (JCI)
- click on your city and schedule your surgery now done in good hands.
| City | Minimum Price (₱) | Maximum Price (₱) |
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Angeles City |
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Antipolo |
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Bacolod |
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Bacoor |
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Baguio |
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Butuan |
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Cagayan de Oro |
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Caloocan |
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Cebu City |
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Dasmariñas |
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Davao City |
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General Santos |
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General Trias |
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Iligan |
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Iloilo City |
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Las Piñas |
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Makati |
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Malolos |
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Manila |
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Muntinlupa |
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Parañaque |
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Pasay |
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Pasig |
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Puerto Princesa |
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Quezon City |
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San Fernando |
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San Jose del Monte |
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Taguig |
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Valenzuela |
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Zamboanga City |
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Disclaimer
This information is sourced from open platforms and is for general awareness only. Costs may vary based on individual cases. Please consult a qualified doctor for medical advice and explore options within your budget before deciding on the procedure.