Peripheral Nerve Surgery Information

There are two main types of peripheral nerve surgery: peripheral nerve decompression surgery and nerve repair surgery. Peripheral nerve decompression surgery is used when the nerve has become trapped or impinged in some way, but remains structurally intact. Nerve repair surgery is needed when the nerve has become severed or has degenerated.

 

Peripheral nerve decompression is performed most often on the arms, wrists, and hands because the main nerves in this area are prone to compression injury. Symptoms of peripheral nerve compression include weakness, tingling, numbness, and/or pain. The main nerves of the hand and wrist—the median, radial, and ulnar nerves—each serve a different area of the arm and hand. If the parasthesias (odd sensations) occur in a particular region of the hand, peripheral nerve surgery can be directed to that nerve.

 

 

Peripheral nerve surgery may be required in a number of different conditions. In general, there is some physical compression on the peripheral nerve that causes problems; however, there are many reasons that a nerve can become compressed. Often joint inflammation can cause swelling and therefore, in their swollen state, the tissues compress the nerve. Occasionally tumors, both malignant and benign, can press on a peripheral nerve. Bone fractures and other traumatic injuries can disrupt the nerve, too. Carpal tunnel syndrome is an example of nerve entrapment that often requires peripheral nerve surgery.

 

Peripheral nerve decompression surgery is aimed at removing the tissues that are impinging on the nerve. In ulnar nerve entrapment, for example, the nerve often becomes trapped at the elbow or at the wrist in two fairly predictable locations. These locations are widened to accommodate the nerve as it travels through the area. In carpal tunnel release surgery, the bands that cover the wrist are opened. These tough, fibrous bands are usually the anatomical structures that are compressing the median nerve and causing symptoms.

 

The other type of peripheral nerve surgery that is a bit more technically challenging (and also more intriguing) is peripheral nerve repair. While it may seem like science fiction, the notion of nerve repair has been around for more than 1,300 years. When a limb is severed, the idea is to bring the damaged nerve ends back together so that they have a chance to heal. While the concept has been around for more than a millennium, this form of peripheral nerve surgery has yet to be perfected.

 

There are three main approaches to peripheral nerve repair. If the two ends of the nerve have been simply cut, the severed ends are brought back together and the covering in the nerve (epineurium) is carefully and delicately sewn together. This approach works if it can be done without putting any tension on the nerve.

 

In some instances, though, one or both ends of the nerve will retract, especially if surgery does not occur immediately after the injury. In this case, nerve repair is performed using a nerve graft. In this form of peripheral nerve surgery, a small bit of nerve, usually from another location in the patient’s body, is sewn into the gap between the severed nerve ends. For very long gaps, a process called nerve transfer is performed. This peripheral nerve surgery obviously requires a very long donor nerve.

Thermage cost varies widely depending on your region of the country and world. Reported costs range from $1,500 to $7,500 but the average Thermage cost is around $2,700. As the technology becomes more widely available, Thermage cost may decrease, however patients may need to pay a higher surgeon’s fees for the Thermage CPT (vibrating apparatus).