Microsurgical neurolysis is a surgical procedure aimed at releasing a peripheral nerve from compressive scar tissue, adhesions, surrounding soft tissues, or pathological formations. The primary goal of the operation is to restore normal nerve function, relieve pain, and improve sensory and motor performance.
Indications for microsurgical neurolysis
The procedure is indicated in the following conditions:
- Entrapment (tunnel) syndromes: carpal tunnel, cubital tunnel, tarsal tunnel, and others.
- Post-traumatic scarring: nerve compression following injuries or previous surgical interventions.
- Nerve compression caused by tumors or space-occupying lesions.
- Inflammatory processes: chronic neuritis leading to secondary nerve compression.
- Chronic compressive neuropathies resulting from prolonged pressure on peripheral nerves.
Types of neurolysis
- External (epineural) neurolysis. Removal of scar tissue or pathological structures surrounding the nerve without violating its internal anatomy. Used when compression is caused by adjacent tissues.
- Internal (endoneural) neurolysis. Dissection of adhesions within the nerve and separation of individual fascicles. Applied in more severe or complex nerve injuries.
- Combined neurolysis. A combination of external and internal techniques in complex clinical cases.
Preoperative preparation
- Diagnostic evaluation: electromyography (EMG), nerve ultrasound, MRI of soft tissues.
- Preoperative assessment: complete blood count, biochemical blood tests, coagulation profile, and neurological consultation.
Surgical technique
- Anesthesia. Local or general anesthesia depending on the extent and complexity of the procedure.
- Surgical approach. A targeted incision is made over the affected area to expose the involved nerve.
- Nerve release. Careful removal of scar tissue, adhesions, or pathological structures. In internal neurolysis, individual nerve fascicles are meticulously separated.
- Microsurgical technique. Use of an operating microscope and fine microsurgical instruments to minimize trauma to the nerve.
- Wound closure. Layer-by-layer suturing of tissues; drainage placement if required.
Postoperative period
- Immobilization. Temporary fixation of the limb or operated area to reduce mechanical stress.
- Pharmacological therapy. Analgesics (NSAIDs), neuroprotective agents to support nerve recovery, and B-complex vitamins to enhance nerve regeneration.
- Physiotherapy. Electrophoresis and magnetotherapy to improve local circulation and healing.
- Rehabilitation. Therapeutic exercises to restore motor function and massage to reduce muscle tension.
Microsurgical neurolysis is an effective treatment for compressive and post-traumatic peripheral nerve lesions. Modern microsurgical techniques provide a high level of safety and allow restoration of nerve function when the procedure is performed in a timely manner.
In Belarus, microsurgical neurolysis is performed in modern medical centers equipped with advanced technology. Highly qualified specialists ensure an individualized approach for each patient. Affordable treatment costs make Belarus an attractive destination for patients from abroad.
