Internal neurolysis.

Abstract

One hundred seventy-eight patients diagnosed with a lower extremity nerve compression syndrome were treated conservatively using orthopedic, medical, and physical therapy modalities. Eighty-two per cent of these patients improved and recovered, and required no further care. Eighteen per cent of these patients did not recover or experience significant improvement in their sensory or motor loss. This chronic group was treated by internal neurolysis. Ninety-five per cent of this chronic group treated by internal neurolysis improved. Only 5% did not have significant prolonged relief or improvement and eventually required excision of a sensory peripheral nerve. Internal neurolysis may not be indicated in those patients who suffer from transient sensory paresthesias; conservative care and/or an external peripheral nerve decompression may suffice. Internal neurolysis is indicated in those patients who have constant sensory aberations or motor loss from a chronic peripheral nerve compression syndrome or any other nerve lesion that has not responded well to conservative care or to an external nerve decompression procedure. Internal neurolysis, in addition to conservative care regimes presented here, has been found to be effective in reversing heretofore thought to be irreversible pain syndromes in the lower extremity even when significant atrophy has already occurred.