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Peripheral nerve vein wrapping for intractable lower extremity pain
1Union Memorial Orthopedics, Baltimore, MD 21218, USA.
Foot & Ankle International
|July 7, 2000
Summary
Vein wrapping effectively treats lower extremity nerve pain from scar tissue, but is less helpful for nerve damage. This procedure offers substantial symptom improvement for many patients with chronic pain.
Area of Science:
- Neurology
- Surgical Procedures
- Pain Management
Background:
- Intractable lower extremity pain often stems from peripheral nerve issues.
- Adhesive neuralgia and intraneural damage are common causes of chronic nerve pain.
- Effective management strategies for these conditions are crucial.
Purpose of the Study:
- To evaluate the efficacy of peripheral nerve vein wrapping for intractable lower extremity pain.
- To determine if vein wrapping is more effective for adhesive neuralgia than intraneural damage.
Main Methods:
- Retrospective review of 25 patients with chronic lower extremity peripheral neuralgia.
- Treatment involved revision neurolysis and vein wrapping using saphenous vein autograft or fetal umbilical vein.
- Pain and dysfunction were assessed using a 0-10 scale, with follow-up averaging 24 months.
Main Results:
- Average pain scores decreased from 8.7 to 4.6; dysfunction scores improved from 7.3 to 4.4.
- 17/25 patients were satisfied, but only 14/25 would repeat the surgery.
- No improvement was observed in patients with idiopathic etiology or intraneural damage.
Conclusions:
- Vein wrapping is most effective for symptoms of adhesive neuralgia, offering less benefit for intraneural damage.
- The procedure provides substantial improvement for scar entrapment of peripheral nerves.
- Complete symptom relief is rare, but significant improvement is typical.