gms | German Medical Science

55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

25. bis 28.04.2004, Köln

Coverage of painful peripheral nerve neuromas with vascularized soft tissue: Method and results

Die Behandlung schmerzhafter peripherer Nervenneurome mittels vaskularisierten Weichteilläppchen: Methode und Ergebnisse

Meeting Abstract

Suche in Medline nach

  • corresponding author Kartik G. Krishnan - Neurochirurgische Klinik, Universitätsklinikum Carl Gustav Carus, Dresden
  • T. Pinzer - Neurochirurgische Klinik, Universitätsklinikum Carl Gustav Carus, Dresden
  • G. Schackert - Neurochirurgische Klinik, Universitätsklinikum Carl Gustav Carus, Dresden

Deutsche Gesellschaft für Neurochirurgie. Ungarische Gesellschaft für Neurochirurgie. 55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie. Köln, 25.-28.04.2004. Düsseldorf, Köln: German Medical Science; 2004. DocP 13.141

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2004/04dgnc0425.shtml

Veröffentlicht: 23. April 2004

© 2004 Krishnan et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective

Our aim is to describe a method of treating painful peripheral nerve neuromas by means of vascularized tissue coverage, report the results in eight patients and discuss the indications for this treatment modality. An analysis of pain, functionality of the affected body part, professional activities of the patients and medications before and after surgery is presented.

Methods

Eight patients (mean age: 45.1 years; all males) with post traumatic nerve injuries, who had developed painful stump neuromas or neuromas-in-continuity and who had unsuccessfully undergone several treatment procedures, were selected for the surgery described here. Surgery included resection of the stump neuroma (4 patients) or neurolysis of the neuroma-in-continuity (4 cases) and coverage of the nerve with a vascularized fascial or fasciocutaneous or perforator flap (4 pedicled regional flaps; 4 free flaps). A modified quadruple visual analogue scale (QVAS) was used to quantify pain before and after surgical treatment. The mean follow-up was 20.6 months.

Results

The mean values of the QVAS (pain now/ typically/ at its best/ at its worst) before surgery were 6.5/6.5/4.7/7.9. These values changed to 0.3/0.4/0/0.9 at a mean follow-up of 20.6 months after surgery. Six patients returned to their original profession, one receives a pension and one took-up a less demanding job after surgery. 6/8 patients received opioids before surgery (one of them had a spinal cord stimulator). After surgery, all patients stopped taking regular pain killers, the SCS was deactivated in one, and two patients still occasionally take NSAID’s, but not on a regular basis.

Conclusions

Vascularized soft tissue coverage of painful peripheral nerve neuromas seems to be an effective, attractive and, at the same time, complex method of treatment. This option may be considered and reserved for patients, who have already undergone several pain treatment modalities without success.