Peripheral Nerve

While neurosurgeons spend most of their time treating the brain and spinal cord, neurosurgical problems also extend to the peripheral nerves. These cord-containing bundles of nerve fibers carry information to and from the spinal cord. Functioning like telephone cables, peripheral nerves are comprised of tiny axon fibers covered with a tough outer layer. These axons deliver electrical signals. When signals are delayed, interrupted, or misinterpreted, patients experience peripheral nerve disorders.

Peripheral Nerve Injury & Healing

Unlike the central nervous system (made of the brain and spinal cord), the peripheral nerves have the ability to regrow into an area of degeneration at an average rate of 1mm/day. Since the process takes months to years to finish, the supplied muscle will weaken and atrophy. Advances in the rate of nerve regrowth are currently being studied, but at this point, there is no single technique that has markedly improved Mother Nature’s rate of recovery.

Common Peripheral Nerve Problems

• Carpel tunnel syndrome: One of the most common peripheral nerve disorders, where the median nerve is compressed by an overlying ligament in the wrist. This nerve entrapment causes numbness in the thumb, index, and middle fingers.
• Cubital tunnel syndrome (ulnar nerve entrapment): Also fairly common, cubital tunnel syndrome manifests itself as elbow pain or sensory loss of the ring and pinky fingers. It may be preceded by an elbow injury.
• Fibular tunnel syndrome (peroneal nerve compression): Though less common than carpal tunnel and ulnar nerve syndrome, fibular tunnel syndrome is potentially more devastating. Peroneal compression can lead to foot drop that may require ankle bracing. Other symptoms include lower leg and top-of-foot numbness.

Non-Surgical Treatment of Peripheral Nerve Injuries

After evaluating a patient using electrical nerve conduction studies , diagnostic imaging, and a detailed physical examination, initial treatment includes bracing of the affected area and medication therapy like non-steroidal anti-inflammatories (NSAIDs) or anticonvulsants like Neurontin. Patients are also directed to avoid actions that may aggravate the condition.

Surgical Treatment for Peripheral Nerve Injuries

When conservative management fails, the next step in peripheral nerve treatment may be surgical. Worsening neurologic function and quality of life changes are also universal reasons to consider surgery. Incisions can be made in a minimally invasive way with little to no scar formation, and interoperative magnification has drastically improved surgical techniques and outcomes. Though peripheral nerve problems are rarely considered emergencies, they warrant careful, step-by-step evaluation.

Why Choose Princeton Brain, Spine & Sports Medicine NeurosurgeonsThe team at PBSSM provides comprehensive treatment for peripheral nerve injuries, including conservative medical management, physical therapy, nerve decompression surgeries, and more. To request a consultation for peripheral nerve symptoms, contact our PA or NJ offices online or by calling 609.921.9001 (NJ) or 215.741.3141 (PA).