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Related Concept Videos

Psychosurgery01:30

Psychosurgery

126
Psychosurgery, the surgical alteration or permanent removal of brain tissue to alleviate severe psychological conditions, stands as one of the most radical and controversial treatments in the history of mental health care. Its development and application have evolved significantly, marked by dramatic shifts in scientific understanding and ethical perspectives.
Historical Development of Psychosurgery
In the 1930s, Portuguese neurologist Antonio Egas Moniz introduced a surgical procedure designed...
126

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Related Experiment Video

Updated: Oct 8, 2025

Author Spotlight: Regenerative Peripheral Nerve Interface (RPNI) Surgery in Postamputation Pain Management
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Risks of therapeutic versus prophylactic neurectomies.

Xiaoxi Feng1, Negin Fadaee2, Desmond Huynh1

  • 1Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.

Surgical Endoscopy
|January 4, 2022
PubMed
Summary

Prophylactic neurectomy is safe, significantly reducing pain without causing neuralgia. Therapeutic neurectomy, however, carries a high risk of persistent neuralgia and complications like CRPS.

Keywords:
AblationChronic painNeuralgiaNeurectomyNeuroma

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Area of Science:

  • Surgical innovation
  • Pain management
  • Neurology

Background:

  • Peripheral nerve injury can lead to chronic pain requiring surgical neurectomy.
  • Neurectomies are also performed prophylactically, for example, during inguinal mesh removal.
  • Outcomes and risks of neurectomies are not well-documented.

Purpose of the Study:

  • To evaluate the outcomes and risks of prophylactic versus therapeutic neurectomies.
  • To compare the incidence of postoperative neuralgia after different types of neurectomy.
  • To identify risk factors for severe complications such as complex regional pain syndrome (CRPS).

Main Methods:

  • Retrospective analysis of patients who underwent neurectomy between 2013 and 2020.
  • Data collected included demographics, preoperative symptoms, and postoperative outcomes.
  • Indications for neurectomy were classified as therapeutic (preoperative neuralgia) or prophylactic (intra-operative necessity).

Main Results:

  • 122 neurectomies were performed on 66 patients; 64% were therapeutic and 52% prophylactic.
  • Prophylactic neurectomy significantly reduced pain (2.5 points, p=0.002) with no resulting neuralgia.
  • Therapeutic neurectomy had a 35% risk of persistent neuralgia, with 9% requiring further intervention; 3 patients developed CRPS.

Conclusions:

  • Prophylactic neurectomy appears to be a safe procedure with positive pain outcomes.
  • Therapeutic neurectomy carries significant risks, including persistent neuralgia and progression to CRPS.
  • Neurectomy decisions should be judicious, especially in patients with pre-existing chronic pain, after exhausting less invasive options.