Nerve Surgery

What is a Nerve Repair?

A nerve repair is a surgical procedure performed to repair a nerve injury and restore normal nerve function allowing transmission of sensory and motor signals to and from the brain respectively. It is often performed as part of plastic and reconstructive surgery.

Causes of Nerve Injury

Damage to the nerves can be caused by too much pressure on the nerve, stretching of the nerve, or a laceration of the nerve. Nerve injuries can occur from blunt trauma, motor vehicle accidents, or cuts from sharp objects. The upper and lower extremities are common sites of nerve injuries.

Signs and Symptoms of Nerve Injury

The common signs and symptoms of nerve injury are:

• Loss of Sensation at the Injury Site: This is an indication of injury to the sensory nerves that transmit impulses from the body part to the brain.
• Muscle Weakness: This is an indication of injury to the motor nerves that transmit impulses from the brain to the body part.
• Pain: This may be felt anywhere along the course of distribution of the nerve but is usually felt at the site of injury.

Indications for Nerve Repair

On the initial evaluation, the sensory and motor function of the injured body part will be tested. If severe injury is suspected, an MRI study may be done to directly visualize the nerve. In case there is a possibility that the nerve may heal itself, a wait and watch approach may be followed. Serial EMG and nerve conduction studies may be ordered at regular intervals to look for signs of recovery of nerve function. If there are no signs of improvement, a nerve repair surgery may be indicated.  

Preparing for Nerve Repair Surgery 

Specific instructions will be provided by your surgeon. In general, you should:

• Inform your surgeon about any health conditions, allergies, and regular medications.
• Avoid smoking as it can slow down the healing process.
• Follow the pre-surgery dietary restrictions.

Nerve Repair Surgery

The nerve repair surgical procedure may involve the following steps:

• General anesthesia will be administered so you will be asleep during the procedure.
• A surgical microscope will be used to examine the injured nerve.
• Scar tissue and debris will be removed from the injury site.
• The torn ends of the nerve are reconnected without stretching the nerve with special surgical instruments.
• If there is significant loss of nerve tissue such that the ends of the nerve cannot be connected, a nerve graft will be done by harvesting a nerve from another part of your arm or leg; or a special tube made of biologic or synthetic material will be used to connect the torn nerve endings together.

Recovery after Nerve Repair Surgery

You may be discharged home on the same day as the surgery; however, you will need someone to drive you home. Depending on the location of the nerve injury, you may need help with activities of daily living for a few days. Full recovery of nerve function may take 6 months to a year or even longer. During this period, you may have regular follow-up visits to determine how well the nerve is healing.

Risks of Nerve Repair Surgery

Nerve repair surgery is a very safe procedure that is performed using minimally invasive techniques to minimize damage to surrounding tissues. However, as with any surgery, there is a minimal risk of infection, bleeding, delayed healing, and failure to recover nerve function.