Peripheral Nerve Decompression Surgery
Nerve decompression surgery is a well proven surgical technique that has been around for a long time. However, it has been under utilized. We have an increasing understanding about many conditions that people suffer from who benefit from this technique.
The peripheral nervous system (PNS) are the nerves outside of the central nervous system (CNS). The CNS consists of the brain and spinal cord.
As peripheral nerves travel through the body they will pass through fixed anatomical points or tunnels as they are routed to their final destination. It is at these points the nerves are vulnerable to compression. The compression can be caused by many different problems (for example, trauma, diabetes, abnormal anatomy, etc.) Simply put, if the tunnel is too tight or the nerve is too swollen, there is risk of the nerve being compressed or entrapped.
For example, we know that diabetes causes significant changes to the nerve architecture including swelling and stiffness. A good analogy might be a situation much like placing a balloon in a napkin ring and blowing up the balloon. The napkin ring does not expand but crimps or “compresses” the balloon (the nerve). In cases of trauma, the tissue in the area of the nerve as it passes through the tunnel can be damaged. The result is swelling and inflammation that eventually goes away but leaves behind tightened fibrotic tissue that essentially contracts the tunnel and its surrounding tissue.
There are common, vulnerable anatomic points that are evaluated to see if there are focal nerve compressions at these sites. The most common type or most well known nerve compression syndrome is carpal tunnel syndrome. Amazingly, there are approximately 44 sites (22 on each side) of nerve compression throughout the body.
When performing nerve decompression, the surgeon is releasing the surrounding tissue from the nerve without damaging the nerve. Scar tissue and/or perinueral fibrosis are removed and the nerve is completely mobilized resulting in relief of pressure on the nerve, thus relieving pain. Also, reestablishment of blood flow occurs to that segment of the nerve and a smooth gliding surface for the nerve is provided.