When is Peripheral Nerve Surgery required?
The Nervous System functionally coordinates our bodyís actions. It consists of a Central Nerve System (CNS) and a Peripheral Nerve System (PNS). The CNS encompasses the brain and the spinal cord. The PNS is a complex network of enclosed bundles of long fi bres. The nerves connect the CNS to every part of the body. The sensory nerve fi bres pick up sensorial (visual, tactile, etc.) information from the distant organs (e.g. the eyes, the ears and those away from the brain like the limbs) and carry them to the CNS. In turn, the motor fi bres transmit signals from the brain to the various parts of the body to perform the action. For example, on seeing a fl ower, visual and olfactory information is conveyed to the brain that recognises it and consequently transmits messages to the arm and hand to perform the action necessary to pick the fl ower.
Peripheral nerves can be affected by pathologies (e.g. nerve injuries, entrapments and tumours) which may require surgery. Although nerves usually lie deep under the skin and muscles, they are exposed to physical damage. Nerve injuries occur in 25% of overall traumas. They can occur alone or be associated with other injuries (head injuries, spine injuries, bone fractures, etc.). A nerve injury results in the loss of sensory and motor function in the region (the skin and the underlying muscles) controlled by that nerve. For instance, a humeral fracture associated with a rupture of the radial nerve leads to a wrist drop.
Sometimes the trauma can damage the whole group of the nerves (brachial plexus) controlling the function of the upper limb, with various degrees of functional impairment, the most extreme being a fl ail arm. Such an event is likely to occur in adults after trauma such as motorcycle accidents, or in babies following a diffi cult delivery (Erbís Palsy). If the nerve damage is reversible, spontaneous recovery can occur, but should a nerve rupture be suspected, the only possibility to rescue the patient from severe disability is a surgical reconstruction of the nerve.
|Date of upload: 22nd Nov 2017|
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