Neurectomy is a surgical procedure in which a nerve or section of a nerve is severed or removed.
Cutting a sensory nerve severs its basal lamina tubes.
Without basal lamina tubes to channel the regrowing fibers to their lost connections, over time a painful neuroma or deafferentation pain may develop.
This is why the neurolytic is usually preferred over the surgical sensory nerve block.
This surgery is performed in rare cases of severe chronic pain where no other treatments have been successful, and for other conditions such as involuntary twitching and excessive blushing or sweating.
A neurectomy, also known as nerve resection, is a surgical procedure in which a peripheral nerve is cut or removed.
The main goal is to alleviate neuropathic pain or permanently disable some nerve function.
Neurectomy is considered when other treatments have failed and numbness in the affected area is an acceptable outcome, particularly when the nerve has no motor function.
Common Uses
Neuropathic Pain: to relieve chronic pain that hasn’t responded to nerve decompression or other interventions.
Autonomic Function: It can block functions like excessive sweating or muscle cramps.
Sensory Dysfunction: Used in cases such as vestibular nerve dysfunction to address vertigo, or in cases of painful conditions like Morton’s neuroma.
Types of Neurectomy Procedures Vestibular Neurectomy: Targets the vestibular nerve to relieve vertigo while attempting to preserve hearing.
Endoscopic Neurectomy (Spine): Minimally invasive, used especially for back pain from facet joint issues.
Presacral Neurectomy: Removes nerves transmitting uterine pain signals, sometimes used to treat severe pelvic pain or dysmenorrhea.
Neurectomy for Nerve Entrapment: Applied for conditions like meralgia paresthetica, where pain relief is sought for cutaneous nerve entrapments.
Outcomes Numbness is most expected result is numbness along the area supplied by the nerve.
In certain conditions (like meralgia paresthetica), neurectomy has been found to be more effective than decompression, with high rates of pain relief.
Risks: Potential complications include neuroma formation, denervation leading to muscle weakness or support loss, and, depending on the site, risks like hearing loss, infection, and other localized effects.
Typically performed under general anesthesia, and surgeons use imaging guidance, to make incisions, and cut the target nerve.
The nerve end may be cauterized (burned) to prevent regrowth.