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Preventive Approach to Phantom Limb Pain in Lower Limb Ablation Surgery: A Systematic Review
Muhammad Phetrus Johan1, Leonard Christianto Singjie1, Jainal Arifin1
1Orthopedic and Traumatology Hasanuddin University.
Orthopedic Reviews
|October 3, 2025
Summary
Preventing phantom limb pain in amputees is crucial. Surgical and non-surgical methods, including nerve coaptation and mirror therapy, show promise in reducing pain and improving quality of life.
Area of Science:
- Pain Management
- Neurosurgery
- Rehabilitation Medicine
Background:
- Phantom limb pain (PLP) is a significant challenge for amputees.
- Current treatments for PLP have limited effectiveness.
- Prevention strategies are essential to mitigate PLP's impact.
Purpose of the Study:
- To systematically review strategies for preventing phantom limb pain in amputees.
- To identify effective operative and non-operative preventive methods.
Main Methods:
- A comprehensive search of four databases (2014-2024) identified 1781 articles.
- Included studies were human, English-written RCTs or cohort studies on PLP prevention.
- Excluded were animal studies and articles outside the last decade.
Main Results:
- Four RCTs and one cohort study were included.
- Surgical prevention: nerve coaptation with collagen wrapping and submuscular transposition showed better results than neurectomy.
- Non-surgical prevention: epidural dexmedetomidine/calcitonin, oral gabapentin, and mirror therapy yielded positive outcomes.
Conclusions:
- Preventive strategies, both surgical and non-surgical, can decrease phantom limb pain incidence.
- Implementing these methods may enhance amputees' quality of life.
