Neurolysis
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Description
[edit | edit source]
Neurolysis is a the breaking down or freeing up of nerve tissues via surgery or chemical agents. This can be a permanent or temporary change. [1]
External neurolysis is releasing scar tissue from the nerve whilst internal neurolysis is releasing the compressed tissue.[2]
Indications[edit | edit source]
Neurolysis can be used for neural recovery in neuropathies or neural lesions, which includes:
- Sciatica[3]
- Brachial plexus injuries[4]
- Quadrilateral space syndrome[5]
- Peroneal nerve palsy. [6]Peroneal is the third most common neuropathy after median and ulnar.[2]
Mechanisms of nerve injury include contusions, compression, traction, ischaemic, and dissection.[2]
Neurolysis can also be used for chronic intractable pain management. [7]
Post-Op Management[edit | edit source]
Early management[edit | edit source]
Rehabilitation[edit | edit source]
Promoting nerve regeneration requires a varied treatment plan, aiming for sensory and motor cortical remapping. This can include:
- Strengthening exercises
- Manual therapy
- Hydrotherapy[8]
- Neuromuscular electrical stimulation[4]
- Combined neurocognitive training[9]
Complications[edit | edit source]
Risk of complications is low but includes postoperative infection, wound dehiscence, hematoma, bleeding, relapse of the neuropathy or sepsis. [6]
References[edit | edit source]
- ↑ Tariq RA, Mueller M, Green MS. Neuraxial Neurolysis. [Updated 2022 Sep 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK537157/
- ↑ 2.0 2.1 2.2 León-Andrino A, Noriega DC, Lapuente JP, Pérez-Valdecantos D, Caballero-García A, Herrero AJ, Córdova A. Biological Approach in the Treatment of External Popliteal Sciatic Nerve (Epsn) Neurological Injury: Review. J Clin Med. 2022 May 16;11(10):2804. /
- ↑ Veihelmann A. Spinal Injections, Epidural Neurolysis and Denervation for Specific Low Back Pain and Sciatica. Z Orthop Unfall. 2019 Aug;157(4):417-425. English, German.
- ↑ 4.0 4.1 Rich JA, Newell A, Williams T. Traumatic brachial plexus injury rehabilitation using neuromuscular electrical muscle stimulation in a polytrauma patient. BMJ Case Rep. 2019 Dec 23;12(12):e232107.
- ↑ Zurkiya O. Quadrilateral space syndrome. Cardiovasc Diagn Ther. 2021 Oct;11(5):1112-1117.
- ↑ 6.0 6.1 Chow AL, Levidy MF, Luthringer M, Vasoya D, Ignatiuk A. Clinical Outcomes After Neurolysis for the Treatment of Peroneal Nerve Palsy: A Systematic Review and Meta-Analysis. Ann Plast Surg. 2021 Sep 1;87(3):316-323.
- ↑ S. Safavi-Abbasi, I. Feiz-Erfan, A.G. Shetter, Neurolysis, Editor(s): Michael J. Aminoff, Robert B. Daroff, Encyclopedia of the Neurological Sciences (Second Edition), Academic Press, 2014. Pages 406-407. Available from: http://www.sciencedirect.com/science/article/abs/pii/B9780123851574007697
- ↑ 8.0 8.1 Novak CB, von der Heyde RL. Rehabilitation of the upper extremity following nerve and tendon reconstruction: when and how. Semin Plast Surg. 2015 Feb;29(1):73-80.
- ↑ Gohritz A, Laengle G, Boesendorfer A, Gesslbauer B, Gstoettner C, Politikou O, Sturma A, Aszmann OC. Nerve Transfers for Brachial Plexus Reconstruction in Patients over 60 Years. J Pers Med. 2023 Apr 12;13(4):659.
