Sometimes, surgery is the best treatment approach for a nerve condition. Penn Nerve Center specialists plan each surgical case carefully, taking into consideration your medical history and functional goals. Once the team has agreed upon the best approach, they will meet with you to discuss the options, risks, and benefits of surgery. Having this information at hand allows you to make an informed decision about your care.
Our surgeons bring the highest degree of skill and expertise to each case. Using the latest technology and approaches, we offer the full range of surgical treatment options presently available for nerve conditions.
- Carpal Tunnel Release/Decompression: This outpatient procedure can be performed using open or endoscopic surgical techniques. During carpal tunnel release your surgeon will make an incision in the wrist and cut the ligament that forms the roof of the carpal tunnel to relieve pressure. Pain and numbness often improve soon after surgery, however, weakness can take time to improve. Repetitive use of the hand and hyperextension of the wrist should be avoided for about a month. Tenderness at the incision site for months following surgery is common.
- Cubital Tunnel Release/Decompression: This outpatient procedure can be performed using open or endoscopic surgical techniques. During cubital tunnel release your surgeon will make an incision in the elbow and cut the ligament that forms the roof of the cubital tunnel to relieve pressure. Pain and numbness often improve soon after surgery, however, weakness can take time to improve. Repetitive use and hyperextension of the elbow should be avoided for about a month. Tenderness at the incision site for months following surgery is common.
- Dorsal Root Entry Zone (DREZ) Procedure: This minimally-invasive procedure sends high-frequency radio waves into a nerve that has become detached from the spinal cord and is causing severe pain. The goal is to silence the nerve fibers so that they can no longer send pain signals to the brain.
- Gracilis Free Functional Muscle Transfer: The brachial plexus is a network of nerves originating in the spinal cord that control muscle movement and sensation in the shoulder, arm, and hand. Patients who have suffered devastating avulsion injuries where a ligament or tendon is pulled away from the bone at the brachial plexus, which can cause paralysis in the upper extremities, may benefit from Gracilis Free Functional Muscle Transfer. During this treatment, microsurgical techniques are used to transplant the gracilis muscle from your inner thigh up to the arm to replace the paralyzed bicep muscle. In approximately 70 percent of cases, useful elbow flexion is restored to the previously paralyzed limb.
- Nerve Grafting: Patients may receive a nerve graft following a brachial plexus or traumatic nerve injury. During this procedure, your surgeon takes a healthy piece of nerve from another location on your body and uses it to reconnect the two ends of the damaged nerve. Generally, an overnight hospital stay is required for this procedure. After surgery, mobility is often limited for three weeks using a sling, brace or splint. Once your surgeon sees you for a follow up visit, they will then encourage mobilization and the start of therapy services.
- Nerve Transfers: This complex microsurgical procedure involves harvesting available nerves from other parts of the body and transplanting them into the nerves of the injured muscle. Recovery time and outcomes depend largely on the severity of the injury. Function begins to return once nerves grow into the muscle. It's often months before active motion returns. Complete healing can sometimes take years.
- Nerve Stimulation: This treatment for neuropathic pain uses gentle electrical impulses to stimulate a peripheral nerve. These impulses stop pain signals from traveling to the nerve, replacing the sensation with the feeling of "pins and needles." During this treatment, electrode leads are implanted under the skin and connected to a battery powered impulse generator (IPG). The IPG is secured under the skin and a hand-held device controls it remotely.
- Tumor Resection: The goal of tumor resection is to remove the tumor while preserving the nerves as best as possible. Your surgeon will work with a member of the radiology team to accurately locate the tumor and determine the optimal incision point. During surgery, your clinical team will monitor electrical nerve conduction and ensure the tumor is removed in the safest way possible. If nerve damage does occur when removing the tumor, it can often be repaired during the same procedure.
- Radiation Therapy: Radiation therapy uses high-energy radiation from X-rays, protons, gamma rays or other energy sources to destroy harmful cells. Sometimes radiation is needed in addition to tumor resection. It is used most commonly for malignant peripheral nerve sheath tumors or other malignancies affecting the nerves.