What is TMR surgery?
Unlike bone, muscle, blood vessels and skin, the nerve remains alive and well after amputation. After transection, the nerves will bud and grow into the surrounding scar tissue and form a neuroma. This is one of the peripheral nervous system mechanisms that can contribute to neuropathic and phantom pain. Pain can be induced by spontaneous ectopic activity in these nerve endings or by chemical and mechanical stimulation. Although all transected nerves form neuromas, not all neuromas cause neuropathic or phantom pain.
Targeted Muscle Reinnervation when you have painful swellings or limb pain
For painful swelling at the end of nerves in an amputation stump or for nerve pain that cannot be treated with analgesics, a so-called “targeted muscle reinnervation” or “targeted nerve/muscle restoration” operation can be performed. This operation involves precise suturing of nerves that controlled the forearm or lower leg muscles but have become idle due to the amputation of the motor nerve unit of the remaining muscles of the stump. That way, the idle nerve is given something to do again, giving the signals fired in the brain a purpose. After decades of research on how to treat neuromas, this is a promising development for people with amputation and nerve pain.
Who can benefit from Targeted Muscle Reinnervation surgery?
Those interested in the procedure to better control their prosthetic arm must undergo a medical review to determine their eligibility. In general, patients must meet the following criteria:
- Amputation above the elbow or at shoulder within previous ten years as stated in the medical records
- In case of stable soft tissues
- Willing to participate in rehabilitation
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