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[Iatrogenic nerve injuries. Part 1: Frequency distribution, new aspects, and timing of microsurgical treatment]
T Kretschmer1, G Antoniadis, W Börm
1Neurochirurgische Klinik der Universität Ulm am BKH Günzburg, Günzburg. kretschmerthomas@hotmail.com
Objective:
The aim of this study was to analyze the number and types of iatrogenic nerve injuries operated on during a 13-year period at a relatively busy nerve center.
Method:
Retrospective analysis was done of 191 cases surgically treated because of iatrogenic nerve injuries.
Results:
Most iatrogenic nerve injuries occurred after surgical procedures. As a rule, symptoms and signs appeared immediately after the procedure. Single nerves most often involved were the spinal accessory nerve at the neck ( n=27), most frequently after lymph node biopsy, and the median nerve in the carpal tunnel ( n=25), usually after carpal tunnel release and most frequently after endoscopic technique. Following in frequency are the common peroneal nerve ( n=16), superficial sensory radial nerve ( n=13), genitofemoral ( n=12), and superficial peroneal and tibial nerves ( n=9 each). Clinical improvement after neurosurgical intervention appeared in 70% of cases. Frequently iatrogenic nerve lesions are referred with significant delay, that is, not during a time interval deemed appropriate for surgical intervention.
Conclusion:
Iatrogenic nerve lesions must be recognized in a timely manner and should be operated upon as early as other traumatic nerve injuries to ensure best chances for successful recovery.