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Author Spotlight: Advancements and Challenges in Surgical Treatments for Postamputation Pain
Published on: March 8, 2024
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Targeted Muscle Reinnervation to Reduce Postoperative Pain in Patients Undergoing Hindquarter Resections
Mikaela H Sullivan1, Gavin L Mills1, Hiba Saifuddin2
1Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, U.S.A.
Anticancer Research
|July 27, 2023
Summary
Pre-emptive targeted muscle reinnervation (TMR) during hindquarter amputation can reduce phantom limb pain (PLP) and neuroma pain. This technique offers an alternative to long-term pain medication dependence.
Area of Science:
- Surgical Innovation
- Pain Management
- Neuroscience
Background:
- Phantom limb pain (PLP) affects up to 90% of hindquarter amputation patients.
- Painful neuromas occur in 50% of these patients.
- Limited literature exists on targeted muscle reinnervation (TMR) for hindquarter amputations.
Approach:
- Cadaveric dissection identified accessible motor nerves (sciatic, femoral, obturator) for TMR.
- Clinical case review of patients undergoing hindquarter amputation with TMR was performed.
Key Points:
- Accessible neuroanatomy for TMR in hindquarter amputations was confirmed.
- Patients undergoing TMR used pain medication for significantly shorter durations.
- No patients reported debilitating phantom limb pain or neuroma pain post-TMR.
Conclusions:
- Pre-emptive TMR is a viable surgical option for hindquarter amputations.
- TMR can effectively limit phantom limb pain and neuroma pain.
- Consider TMR to reduce reliance on pain medications.
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