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Directed cutaneous neurectomy for cutaneous neuralgia
Charles E Lucas1, Anna M Ledgerwood1
1Detroit Receiving Hospital, 2nd Floor, 2V, 4201 St. Antoine, Detroit, MI, 48201, USA.
American Journal of Surgery
|June 4, 2023
Summary
Directed cutaneous neurectomy (DCN) offers effective relief for persistent cutaneous neuralgia (CN). This surgical approach, involving precise nerve excision guided by blockade, successfully treated most patients, providing lasting pain relief.
Area of Science:
- Surgical Neurology
- Pain Management
- Nerve Surgery
Background:
- Cutaneous neuralgia (CN) presents a frequent challenge in surgical consultations.
- Persistent CN often requires advanced treatment strategies.
Purpose of the Study:
- To describe the efficacy of directed cutaneous neurectomy (DCN) for treating persistent CN.
- To evaluate the outcomes of DCN in a patient cohort.
Main Methods:
- DCN was performed 112 times in 100 patients between 2010 and 2022.
- A percutaneous proximal blockade with blue dye guided the excision of affected tissue.
- Procedures were performed on the groin, abdomen, chest, extremity, and skull.
Main Results:
- Continuous pain relief was achieved in 82 patients (mean duration 27 months).
- Temporary relief was noted in 12 patients, with some requiring repeat procedures.
- No relief was reported in 6 patients, with two experiencing relief after a second DCN.
Conclusions:
- Directed cutaneous neurectomy is a successful treatment for refractory cutaneous neuralgia.
- The presence of nerve fibers or mesh did not impact treatment outcomes.
