Treatment of recurrent peripheral nerve entrapment problems: role of scar formation and its possible treatment

Surgical management of peripheral nerve entrapment syndromes is usually successful, but the recurrence of symptoms after initial improvement can and does occur. Extraneural fibrosis is one possible cause of recurrent peripheral nerve problems as a result of nerve compression or tethering. Several approaches to prevent extraneural scarring after surgery have been studied, including wrapping the involved nerve with a graft, the application of various chemical compounds, and radiation. ADCON-T/N, an antiscar bioabsorbable gel device was evaluated in a retrospective clinical review. Sixty-seven percent of patients treated with ADCON-T/N after reoperation of a peripheral nerve experienced prolonged clinical improvement compared with 50% of patients who did not receive ADCON-T/N. These preliminary results suggest that ADCON-T/N may prove to be clinically useful in the surgical treatment of peripheral nerve problems. Additional more rigorous clinical studies are necessary, however.