Unlike injuries to the central nervous system, treatment for peripheral nerve injury is possible and has shown to be successful in many cases. Peripheral nerves can heal; however, it is important for a person with a suspected peripheral nerve injury to consult with a healthcare professional. The chance for restoring nerve function may diminish over time.
Treatment for peripheral nerve injury can vary for each patient. Injuries are treated depending on the underlying cause of the symptoms.
This page provides information on treatment options for Severed Nerves and Compressed Nerves.
Treatment Options for Severed Nerves
Several factors play a role in improving the success of the nerve repair. Some of these factors are the of the patient, degree of injury, type of nerve injured, time since injury, location of the injury, and type of repair. It is important that a person with a suspected peripheral nerve injury consult with a healthcare professional.
Below are common options available for the surgical treatment of transected nerves:
A common bridging material is an autologous nerve graft or nerve autograft. A nerve autograft is a nerve taken from another part of your body and used to bridge a gap in an injured peripheral nerve. The surgeon will surgically remove the healthy nerve from your body, typically the sural nerve from your leg, and suture it into the nerve gap. This provides a bridge of your own tissue to guide the regenerating nerve as it grows to the other side. Use of the autograft nerve requires a second surgical site and may result in numbness where the nerve was removed.
Processed Nerve Allograft
Processed nerve allograft is donated human peripheral nerve that is used to bridge the nerve gap. It provides a bridge of nerve tissue and micro-architecture. Allograft nerves are donated just like other tissues and organs donated across the country. These donors must go through a rigorous screening process before being selected. The nerve is processed and sterilized to mitigate the risk of donor-to-recipient disease transmission. This procedure does not require a second surgical site. Processed nerve allograft does not require immunosuppression and provides a bridge for the nerve which will eventually be incorporated into your body and become your own tissue.
Hollow Tube Conduit
A hollow tube conduit is used by a surgeon to connect severed nerve ends. The conduit provides gross guidance for the nerve as it grows to meet the other end. Conduits made of reconstituted collagen or synthetic material are broken down by the body leaving just the underlying nerve. Conduits made from porcine SIS are incorporated and become part of your body. This procedure does not require a second surgical site.
A direct repair may be done when there is no gap between the severed nerve ends and the nerve tissue is healthy. If the nerves can be closely aligned with no tension or nerve stretching, the surgeon may suture the ends together to facilitate healing. In some cases, the surgeon may choose to put a tube or wrap around the repair site to protect it during healing.
Nerve transfer is a surgical procedure that transfers a functioning nerve to take over an area of lost function from nerve damage. A nerve transfer is done by moving a healthy, less important nerve, then connecting it to the damaged nerve near the muscle or organ being innervated. The transferred nerve will now be responsible for transmitting the signals to the target. To be successful, the patient needs to learn how to use the transferred nerve to control the muscle. Similar to an autograft, one major drawback of this procedure is the loss of function at the transferred nerve’s original muscle. However, in some circumstances a nerve transfer may allow for faster nerve function recovery.
Treatment Options for Crushed & Compressed Nerves
The goal for treatment of crushed and compressed nerves is to relieve the pressure and swelling and reduce soft tissue attachments that can hinder nerve movement. Treatment may include use of splints or braces, anti-inflammatory medications, or cortisone injections. If these treatments fail, surgery is considered an option. Surgery may be performed to relieve the pressure that is compressing the nerve. Typically, the surgeon removes as much of the pressure source as possible and the damaged nerve is left to heal.
Nerve wraps have been developed to protect the injured nerve during the healing process. Nerve wraps can act as a cushion or barrier to protect the nerve from the pressure source and minimize attachment to surrounding tissue that can re-entrap the nerve.
Nerve release procedures are surgical operations that help relieve pressure on the entrapped nerve. In carpal tunnel syndrome, the ligaments in the palm of the hand that form the carpal tunnel arch put pressure on the nerve and causes it to become inflamed. In a nerve release procedure a ligament is cut to reduce pressure on the nerve. However, sometimes the nerve becomes re-entrapped in scar tissue and an additional procedure may be required to remove the scar tissue. To help minimize the chances of re-entrapment, a protective nerve wrap may be used.
This is a procedure that slightly adjusts the position of the nerve to accommodate implants or natural obstructions to the nerve. Cubital tunnel syndrome is commonly a candidate for nerve repositioning. The ulnar nerve passes over the back of the elbow and may be stretched or can push against the bone when the arm is bent. In order to provide more space for the nerve and reduce the pressure on it, surgery may be performed to move the nerve to a different area where it will have more room.