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Nerve decompressions are still a relatively new surgery, however a picture emerges from looking at the outcomes of some of the most studied nerve decompressions: carpal tunnel release, sciatic nerve decompression, and migraine surgery. Even within these commonly performed surgeries, the measurement of outcomes is not always standardized.
Migraine surgery is an outpatient procedure which addresses peripheral nerves through limited incisions. Depending on the symptoms of the patient and the screening results following nerve blocks or Botox, different areas of the head and neck may be addressed to treat the nerves found to be the migraine trigger in a given patient.
The problem is difficult to address, and revision surgery is less successful than primary carpal tunnel release surgery. [43] Injury to the median nerve proper occurs in 0.06% of cases. [44] Risk of nerve injury has been found to be higher in patients undergoing endoscopic CTR compared with open, though most are temporary neurapraxias. [45]
Nerve decompressions aim to surgically access and explore some segment of nerve, removing any tissue that may be causing compression. In this way a nerve decompression can directly address the underlying cause of entrapment. A nerve decompression can either be done by open surgery or laparoscopic surgery.
Neurectomy can be an alternative to a nerve decompression for nerve entrapment, such as when the nerves have no motor function and numbness along the dermatome is acceptable. A neurectomy is not a mutually exclusive option to a decompression as a neurectomy can also be used after a failed decompression. [1]
The purpose of cutting the transverse carpal ligament is to relieve pressure on the median nerve, and this is a type of nerve decompression surgery. It is recommended when there is constant (not just intermittent) numbness, muscle weakness, or atrophy, and when night-splinting or other palliative interventions no longer alleviate intermittent ...
In March 2011, investigators from Australia and several other countries published the results of the DECRA [5] trial in The New England Journal of Medicine.This was a randomized trial comparing decompressive craniectomy to best medical therapy run between 2002 and 2010 to assess the optimal management of patients with medically refractory ICP following diffuse non-penetrating head injury.
At the 2007 meeting of the American Society for Surgery of the Hand, a former advocate of endoscopic carpal tunnel release, Thomas J. Fischer, MD, retracted his advocacy of the technique, based on his own personal assessment that the benefit of the procedure (slightly faster recovery) did not outweigh the risk of injury to the median nerve.
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