Peripheral neurosurgery

The introduction of micro-surgical treatment of the peripheral nerves for the removal of bottleneck syndromes (carpaltunnel syndrome, ulnaris syndrome, tarsaltunnel syndrome, supinatorlogen syndrome, loge de guion, thoracic-outlet syndrome, meralgiaparestetica) has led to a significant improvement in operative results. Traumatic nerve injuries can be micro-surgically reconstructed by means of nerve neurolysis, or occasionally via suralis-interponate, in order to obtain a motor, or at least sensitive protective function. Neurinomas and neurofibrobemas can in most cases be removed by means of micro-surgery with no additional loss or failure. Where preservation of function is not expected following tumour resection, the nerve can be reconstructed through inter-positioning of the n. suralis. Tumours of the peripheral nerves, especially those of the armplexus, represent a special entity and in most case can be resected with little or no neurological deficit.

Birth traumatised armplexus paresis and armplexus paresis caused by a fall can be treated in 3 to 6 months, where no adequate re-innervation (one degree of power) is recognisable, supra/infraclavicular, in order to achieve better re-innervation by means of neurolysis / possible interposition of an n. suralis.

Photo: Plexus tumor after surgery (MRI-picture)

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