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Peripheral Nerve Surgery

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At the University of Miami Health System, expert neurosurgeons perform advanced peripheral nerve surgeries to help restore feeling and movement to limbs as well as relieve nerve pain. With two of the few neurosurgeons in Florida who perform these innovative procedures, you can rest assured that you are in the best hands.

Brachial Plexus Injuries

Nerve grafting and transferYour brachial plexus consists of nerves that run from your spine, through your shoulder, and down into your arm. Injuries to this area can cause symptoms like pain, numbness, and weakness.

Causes

Brachial plexus injuries can be caused by trauma from car accidents, gunshot wounds, sports injuries, or injuries to a baby during childbirth.

Diagnosis

Our physicians can diagnose brachial plexus injuries and other peripheral nerve disorders with noninvasive tests, including:

  • Magnetic resonance imaging (MRI). MRIs use magnets and radio waves to create an image of the inside of your body, including your nerves, to look for damage.
  • High-resolution ultrasound. Ultrasound uses acoustic waves to image soft tissues in real-time from multiple angles. It is done by dedicated musculoskeletal radiologists who communicate directly with our surgeons.
  • Nerve conduction studies. During a nerve conduction study, electrodes record how fast an electrical impulse moves through your nerves. These studies can reveal problems in a nerve.
  • Electromyogram. Electromyograms use electrodes to measure the electrical activity in your muscles. They can reveal if the problem is in your muscles and not your nerves.
Treatments

Our neurosurgeons use innovative techniques to treat brachial plexus injuries and other peripheral nerve injuries. To restore your nerve health, we may use one of the following techniques:

  • Nerve grafting. An injury can cause a gap in a nerve that prevents it from working appropriately. During a nerve graft, your neurosurgeon takes part of a nerve from another area of your body or from a donor and attaches it to the injured nerve. The nerve graft can help restore function in the damaged nerve.
  • Nerve transfer. For a nerve transfer surgery, your neurosurgeon connects a nearby working nerve to the injured nerve. Over time, the brain will learn how to use the new nerve to perform the functions of the old, injured nerve.

Peripheral Nerve Injuries

Nerve grafting and transferYour peripheral nerves are all the nerves located outside of your brain and spine. These nerves control movement and feeling in your arms and legs.

When these nerves are affected by an injury, you may experience symptoms like:  

  • Numbness of your limb
  • Pain in your limb
  • Inability to move your limb
Types

Your peripheral nerves can be injured in many ways. They are most commonly injured by gunshot wounds, trauma during car accidents, or cuts in the shoulder area.

Peripheral Nerve Tumors

When tumors develop on your peripheral nerves, they can affect your ability to use the limb and even cause burning pain. You may or may not be able to feel the tumors through your skin. Most peripheral nerve tumors are benign (non-cancerous), but if they cause symptoms, they may need to be removed to relieve pain and restore function.

Types
Tumors may be from different types of cells, including:
  • Nerve cells, which form a neurofibroma
  • Cells for the tissues that cover the nerve, which forms a Schwannoma tumor
Treatments

Our surgeons use advanced techniques to remove tumors from nerves without damaging nerve function. Each surgery is different depending on the location and size of your tumor. Cases are performed with microsurgical techniques and nerve-monitoring to ensure maximum safety.

Entrapment Neuropathies

The most common type of nerve entrapment syndrome, familiar to most, is carpal tunnel syndrome. In this process patients experience pain and numbness in the area supplied by the median nerve due it being pinched at the wrist. Similarly, other nerves can be pinched in the arms or legs.

Types

Various nerves can be compressed by tight ligaments, often near a joint:

  • Median nerve (carpal tunnel syndrome, pronator teres syndrome, etc)
  • Ulnar nerve (ulnar tunnel / guyon’s canal, cubital tunnel syndrome)
  • Lateral femoral cutaneous nerve (meralgia paresthetica)
  • Obturator
  • Tibial nerve (tarsal tunnel syndrome)
  • Peroneal nerve
  • Numerous others
Treatments

Differentiation the source of pain / numbness in your body can be challenging. Our surgeons use diagnostic studies including high resolution ultrasound and electrical studies (described above) to ensure the correct diagnosis. In the operating room we use minimally disruptive techniques to relieve symptoms of pinched nerves. Cases are usually done under mild sedation with the ability to return home that day.

Why Choose UHealth?

Surgical expertise. We see more than 14,000 patients each year and perform more than 4,000 surgeries. Our experienced neurosurgeons are consistently pioneering new treatments. From minimally invasive spine surgeries to awake craniotomies, we offer unique surgeries you cannot find anywhere else in the region to treat your injuries and conditions.

Multidisciplinary team. At UHealth, you have access to the best neurosurgeons in the region. You will be taken care of by a passionate and knowledgeable multidisciplinary team of medical professionals who make sure that you receive the right treatment for your unique condition.

Concierge service. Patients do not have to figure it all out alone at UHealth. Patients are assigned a concierge coordinator who is there for you and your family while you are in our care. They connect you with other providers you may need, walk you through the surgery process, and can answer any questions you or your family may have.

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