Definition

Peripheral nerve surgery is a type of procedure used to treat conditions affecting peripheral nerves. These nerves carry messages between the brain, spinal cord, muscles, skin and other parts of the body. When a peripheral nerve is damaged, compressed or affected by disease, it can cause pain, weakness, numbness or loss of function.

Peripheral nerve surgery may help restore nerve function, reduce nerve pain, improve movement and increase sensation. The procedure may be used for nerve injury, nerve compression, nerve tumors or other peripheral nerve disorders.

Alternative names

Nerve decompression surgery; Nerve graft surgery; Nerve reconstruction; Nerve repair surgery; Nerve surgery; Nerve transfer surgery; Neurological surgery for peripheral nerve conditions; Peripheral nerve microsurgery; Peripheral nerve reconstruction; Peripheral nerve repair; Reconstructive nerve surgery

Treatment

Many people are surprised to learn that a plastic surgeon often performs peripheral nerve surgery. Plastic surgeons receive specialized training in microsurgery, nerve repair, nerve reconstruction and reconstructive surgery.

Depending on your condition, your care team may include a plastic surgeon, a peripheral nerve neurosurgeon, anorthopaedic surgeon or other specialists. These experts work together to improve nerve function and help restore movement and sensation.

The procedure depends on the type and location of the peripheral nerve problem. Common procedures include:

• Nerve repair: A surgeon reconnects the ends of an injured nerve. This may be used for nerve lacerations or traumatic nerve injury.
• Nerve graft: If a gap exists between the ends of a damaged nerve, a nerve graft may be used to bridge the space. A healthy nerve from another part of the body may serve as the graft.
• Nerve transfer: A functioning nerve or nerve fiber is redirected to restore movement or sensation in an area affected by nerve damage.
• Nerve decompression: Nerve decompression surgery relieves pressure on a compressed nerve. This treatment is often used for nerve entrapment and nerve compression conditions.
• Tumor removal: Peripheral nerve tumors may require surgical excision. The surgeon removes the tumor while trying to preserve healthy nerve tissue whenever possible.
• Brachial plexus surgery: The brachial plexus is a network of nerves that controls movement and sensation in the shoulder, arm and hand. Surgery may help repair a brachial plexus injury caused by trauma.

Peripheral nerve surgery is often part of a larger treatment plan. Related treatments may include:

• Bracing or splinting
• Follow-up care with surgeons or specialists
• Imaging studies such as MRI or ultrasound
• Medications for neuropathic pain
• Nerve conduction studies
• Occupational therapy
• Pain management
• Physical therapy
• Rehabilitation exercises

Before the procedure

Your team will evaluate your symptoms and overall health.

You may undergo:

• A physical examination
• A review of medications and medical history
• Blood tests
• Electromyography (EMG)
• Imaging tests
• Nerve conduction studies

You may be instructed to:

• Adjust certain medications if directed
• Arrange transportation home
• Prepare for recovery after the procedure
• Stop eating and drinking before surgery

After the procedure

Recovery varies depending on the type of surgery, the location of the injured nerve and the extent of nerve damage.

After surgery, you may experience:

• Bruising
• Limited movement in the treated area
• Mild to moderate pain
• Swelling
• Temporary numbness

Your healthcare team may recommend:

• Exercises to improve nerve function
• Occupational therapy
• Pain management strategies
• Physical therapy
• Regular follow-up appointments
• Rest and activity restrictions

Nerves heal slowly. Recovery may take several months or longer. Some people continue to improve for up to a year or more after surgery.

Potential side effects

As with any surgery, peripheral nerve surgery carries risks. Potential side effects and complications include:

• Bleeding
• Bruising
• Damage to nearby structures
• Delayed healing
• Incomplete recovery of nerve function
• Infection
• Need for additional surgery
• Ongoing neuropathic pain
• Pain
• Persistent numbness
• Recurrence of nerve compression
• Scarring
• Stiffness
• Swelling

The risk of complications depends on the type of procedure, overall health and the severity of the nerve condition.

Contact your healthcare provider right away if you develop:

• Changes in skin color or circulation
• Drainage from the incision
• Fever or signs of infection
• Loss of movement
• New numbness
• Severe pain that is not controlled by medication
• Significant swelling
• Sudden weakness

Emergency medical care may be needed for severe or rapidly worsening symptoms.

Outlook

The outlook after peripheral nerve surgery depends on the type of nerve injury, how long the nerve has been damaged, the patient’s age and overall health.

Many people experience:

• Better muscle strength
• Improved sensation
• Improved movement
• Increased daily function
• Reduced pain

Results are often best when treatment occurs soon after a peripheral nerve injury or other nerve problem is identified.

Some patients regain full nerve function, while others may continue to have some weakness, numbness or chronic pain. Regular follow-up care and rehabilitation can help maximize recovery.

This entry was written by Jennifer Cruz-Urbano, marketing specialist, and reviewed for accuracy by Bruce Mast, MD, FACS. Generative AI was leveraged as part of the content creation process.