Prevent Post-Amputation Pain with Standard Nerve Surgery
Reading Time: 3 minutes
About six in 10 people develop limb pain after an amputation. While this is common, it doesn’t have to be. Last summer, a collaborative research effort involving the Leiden University Medical Center (LUMC) in the Netherlands and six other Dutch hospitals investigated whether a simple nerve surgery post-amputation can prevent patients from developing this pain.
The conventional approach taken by surgeons has been to either tie off or cauterize the ends of the severed nerves, resulting in nerve damage within the residual limb. Unfortunately, this method leads to post-amputation complications in more than half of the cases, including phantom pain and discomfort in the residual limb. Such pain can significantly disrupt a person’s daily life and often leads to increased reliance on pain medications.
If the ongoing study is successful, the participating institutions plan to implement this nerve treatment as a standard procedure for leg amputations. Initial findings are expected in five years.
Preventing phantom pain
Nerves have a remarkable ability to heal themselves. So, a severed nerve will usually grow back and attempt to reconnect with the nervous system. However, this natural healing process can lead to the formation of nerve scars, which can be quite painful.
In an interview with LUMC News, neurosurgeon Justus Groen explained that the preventative procedure would connect the severed nerve to the nerve endings of the muscles in the residual limb. This approach helps prevent the formation of painful nerve scars, enabling patients to use prosthetic limbs shortly after an amputation.
While this technique is not new and has been shown to be effective, it is typically performed only after a patient has developed post-amputation pain, requiring another surgical procedure weeks or months after the initial amputation.
The study aims to investigate the possibility of performing this nerve surgery as a preventive measure during amputation surgery, while the patient is still on the operating table. It is estimated that this additional procedure would only extend the surgery by about thirty minutes.
The study
A team of vascular surgeons, neurosurgeons, and rehabilitation physicians at LUMC will work together on the research. The protocol involves a vascular surgeon carrying out the leg amputation while a neurosurgeon will connect the nerves.
In addition, rehabilitation physicians play a crucial role in the patient care process post-amputation. They focus on assessing patients’ recovery as well as their effective use of prosthetics.
The study involves 260 patients suffering from peripheral vascular disease, commonly referred to as “intermittent claudication,” requiring leg amputations. This nerve reconnection technique might also apply to individuals who lose their legs due to other medical conditions in the future.
The bottom line
This collaborative effort among specialists at LUMC and six other hospitals could transform the outcomes for patients undergoing leg amputations. If successful, this preventive approach would enhance not only their recovery but also their overall quality of life.
