title: Pilot study of intraoperative ultrasound-guided instrument placement in nerve transection surgery for peripheral nerve pain syndromes.
abstract: Surgical transection of sensory nerves in the treatment of intractable neuropathic pain is a commonly performed procedure. At times these cases can be particularly challenging when encountering obese patients, when targeting deeper nerves or those with a variable branching pattern, or in the case of repeat operations. In this case series, the authors describe their experience with ultrasound-guided surgical instrument placement during transection of a saphenous nerve in the region of prior vascular surgery in 1 patient and in the lateral femoral cutaneous nerve in 2 obese patients. The authors also describe this novel technique and provide pilot data that suggests ultrasound-assisted surgery may allow for complex cases to be completed in an expedited fashion through smaller incisions.
authors.affiliation: Departments of 1 Physical Medicine & Rehabilitation and.
authors.forename: P Troy
authors.initials: PT
authors.lastname: Henning
authors.affiliation: Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota; and.
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Wilson
authors.affiliation: Neurosurgery, University of Michigan, Ann Arbor, Michigan.
authors.forename: Matthew
authors.initials: M
authors.lastname: Willsey
authors.affiliation: Department of Neurosurgery, Henry Ford Health System, Detroit, Michigan.
authors.forename: Jessin K
authors.initials: JK
authors.lastname: John
authors.affiliation: Neurosurgery, University of Michigan, Ann Arbor, Michigan.
authors.forename: Miriana
authors.initials: M
authors.lastname: Popadich
authors.affiliation: Neurosurgery, University of Michigan, Ann Arbor, Michigan.
authors.forename: Lynda J S
authors.initials: LJ
authors.lastname: Yang
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods*; D009437:Neuralgia / Q000000981:diagnostic imaging* / Q000601:surgery*; D010523:Peripheral Nervous System Diseases / Q000000981:diagnostic imaging* / Q000601:surgery*; D010865:Pilot Projects; D013577:Syndrome; D018084:Ultrasonography, Interventional / Q000379:methods*
keywords: BMI = body mass index; LFCN = lateral femoral cutaneous nerve; VAS = visual analog scale; nerve transection; peripheral nerve; surgical instrument; ultrasound guidance