Revisional peripheral nerve surgery

Peripheral nerve disorders are difficult to manage. In the surgical treatment of patients with peripheral nerve pathology, there are a multitude of factors that may alter the outcome of the patient's recovery and lead to incomplete recovery or possibly worsening of symptoms. The anatomy and function of the peripheral nerve is unique and the evaluation and management of these disorders must be approached in a manner different from musculoskeletal disorders. Many anatomic areas can tolerate scar tissue and adhesions, but in peripheral nerves, loss of the gliding functional and adherence to surrounding soft tissue structures is a common complication from over-zealous dissection and repeat peripheral nerve surgery without modification of technique. The approach to each patient must be thorough and individualized to treat their specific condition, and the surgeon must be aware that at times, the most appropriate treatment for the patient may not be medical but surgical management of the chronic pain condition.