Like electrical cords, 43 pairs of peripheral nerves extend from the spinal cord and enable movement, coordination and sensation throughout the body. The pain, tingling, numbness and other discomforts of peripheral nerve injuries can often be treated successfully with physical therapy and other nonsurgical methods. But in some cases, surgery offers the best chance of lasting relief.
Nerve repair surgery aims to restore function and sensation that was partially or completely lost due to nerve damage. For example, if a nerve injury caused paralysis in the arm, the surgery aims to return movement and sensation to the arm.
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Types of Nerve Repair Surgery
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There are different ways to repair a damaged nerve and restore its function. They include:
Direct Nerve Repair
When a nerve is cut sharply (e.g., with glass or a blade), sometimes the ends can be connected back together. This is called direct nerve repair and is usually the first method a surgeon considers.
During this procedure, a surgeon — who may first trim severely damaged tissue at the ends of a nerve — brings the ends together and connects them using a technique such as:
- Suturing or sewing the nerve ends together
- Gluing the nerve ends together with a special glue
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All of these are delicate procedures that require a skilled nerve surgeon.
Nerve Grafting
A nerve graft is used to bridge a gap between the ends of a damaged nerve when the gap is too big to reconnect, which can happen after blunt or crush injuries, or after previous failed repairs. Nerve grafting is similar to grafting of skin or bone. A piece of nerve tissue is taken from somewhere in the body where it is not vital (or from a cadaver) and placed where it is needed.
Nerve Transfer
When reconnecting the ends of a damaged nerve is not a good option, a nerve surgeon may recommend a nerve transfer. During this procedure, a healthy, redundant donor nerve is rerouted to connect to the nonfunctioning, damaged nerve. As the nerve fibers regrow, movement and sensation are restored to the muscles and skin supplied by the damaged nerve.
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