Nerve Reassignment Surgery At Time of Amputation Drastically Reduces Pain in Amputees

Researchers find life-altering benefits to surgery developed for advanced prosthetics

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Researchers at The Ohio State University Wexner Medical Center found that a procedure for amputees that reroutes severed nerves to active nerves in a nearby muscle significantly reduces or eliminates intense pain that amputees commonly experience.

(COLUMBUS, Ohio) – As many as 75 percent of the two million amputees in the U.S. experience debilitating pain, numbness and phantom limb pain. It often makes the use of a prosthetic limb intolerable and requires medication to manage the pain. However, doctors at The Ohio State University Wexner Medical Center have found that a surgery to reroute amputated nerves, called targeted muscle reinnervation, or TMR, can reduce or prevent phantom and residual limb pain from ever occurring in those who receive the procedure at the time of amputation. The procedure can also help amputees who have lived with pain for years.

    “Their pain is caused by disorganized nerve endings in the residual limb that used to connect to muscle, but now have nowhere to go,” says Dr. Ian Valerio, division chief of Burn, Wound and Trauma in the Department of Plastic Surgery. “Attaching those nerve endings to active nerves in a nearby muscle allows the body to rebuild circuits and alleviates phantom and residual limb pain by giving those severed nerves something to do.”

    Only 13 percent of patients who received TMR at the same time as their amputation surgery reported having pain six months later, while reports of phantom limb pain were cut in half in amputees who received TMR months or years after their amputation. Valerio says patients are able to significantly reduce or completely discontinue the use of narcotics and greatly improve their quality of life.

    “Patients who have been living with this constant pain feel relief almost immediately,” says Valerio. “Within the first couple of weeks after surgery, they’ll say that they feel much better and that the pain is greatly reduced or gone completely. This allows them to finally get back to their daily lives and effectively adjust to life without a limb.”

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Dr. J. Byers Bowen (left) and Dr. Ian Valerio follow up with a leg amputee who had targeted muscle reinnervation surgery at The Ohio State University Wexner Medical Center. Those who received the procedure at the time of amputation reported significantly less pain caused by severed nerves.

Robert Haas experienced debilitating pain following the amputation of his left leg that prevented him from using his prosthetic and required medication to manage. However, a surgery that reconnects severed nerves eliminated his pain and allowed him to adjust to life with an artificial limb.

Researchers at The Ohio State University Wexner Medical Center found that a procedure for amputees that reroutes severed nerves to active nerves in a nearby muscle significantly reduces or eliminates intense pain that amputees commonly experience.

Dr. Ian Valerio performs targeted muscle reinnervation surgery at The Ohio State University Wexner Medical Center. Rerouting nerves that were severed during a limb amputation to active nerves in nearby muscles helps prevent phantom and residual limb pain in amputees.

Robert Haas lost his leg after doctors discovered dangerous blood clots, and he suffered with constant pain caused by disorganized nerve endings commonly experienced by amputees. But a procedure that reconnects severed nerves to nearby active nerves allowed him to use his prosthetic pain free and get back to daily life.