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Neurectomy

A neurectomy is a neurosurgical involving the surgical transection or partial resection of a peripheral , typically targeting small sensory nerves to interrupt signals and induce localized numbness for the management of intractable . This intervention is generally considered a last-resort option after failure of conservative therapies, such as medications or less invasive neurolytic blocks, due to its potential for permanent damage. Commonly performed under local or general , the entails precise identification and severing of the affected , often guided by prior diagnostic nerve blocks or imaging to ensure accuracy and limit collateral effects. Neurectomies are categorized by anatomical location and nerve type, with peripheral neurectomy being the most frequent, involving postganglionic branches of nerves like the trigeminal for facial pain or ilioinguinal for groin discomfort. Other variants include dorsal rhizotomy, which targets spinal nerve roots, and specialized approaches like vestibular neurectomy for balance disorders. Key indications include refractory , where peripheral avulsion of terminal branches provides relief lasting 15–24 months or longer with preventive measures against regeneration; chronic syndromes; and following procedures such as , with studies showing significant pain reduction in many cases across various neurectomy techniques. It is particularly suitable for elderly patients or those in remote areas lacking advanced neurosurgical facilities. Neurectomy is also employed in , particularly for managing chronic lameness in horses. Despite its efficacy, neurectomy carries risks including deafferentation pain ( in denervated areas), formation of painful neuromas from regrowth, permanent sensory deficits, and rare motor impairments if mixed nerves are involved; complication rates are low in reported series but underscore the need for careful patient selection.

Definition and Overview

Definition

A neurectomy is a neurosurgical procedure involving the surgical excision, transection, or resection of part or all of a peripheral . The term derives from the Greek "," meaning , combined with "-ektomia," a New Latin form of the Greek "ektomē," denoting a cutting out, from "ek" (out) and "temnein" (to cut). This etymology reflects the procedure's core action of excising neural tissue to achieve therapeutic outcomes. The basic mechanism of neurectomy entails the permanent interruption of conduction, thereby eliminating the transmission of signals or aberrant neural activity along the targeted pathway. Unlike temporary interventions such as blocks, which use pharmacological agents to transiently block function for diagnostic or short-term purposes, neurectomy produces a lasting disruption, often reserved for refractory cases where less invasive options fail. This permanence distinguishes it as a more definitive, albeit irreversible, approach to managing chronic neuropathic conditions. Neurectomy is strictly limited to peripheral nerves, excluding interventions in the due to the higher risks and complexities involved. It encompasses a range of techniques, from complete surgical resection of the segment to partial methods, tailored to the 's size, location, and sensory versus motor function.

Classification of Procedures

Neurectomy procedures are classified based on anatomical location, surgical techniques, and therapeutic purposes to guide clinical and optimize outcomes. Anatomically, neurectomies target peripheral nerves, classified by their location, such as intracranial peripheral nerves within the cranium or (e.g., the for vertigo management), or extracranial peripheral nerves outside these areas (e.g., the intercostal or lateral femoral cutaneous nerves for localized pain syndromes). Furthermore, classifications distinguish autonomic neurectomies, which interrupt sympathetic or parasympathetic pathways (e.g., presacral neurectomy for pelvic visceral control), from those targeting sensory or motor nerves, such as sensory branches in or motor branches in spastic muscle . Technique-based classifications emphasize the method of nerve interruption, including traditional surgical resection via open or laparoscopic approaches, which physically or the for definitive , as seen in open triple neurectomy for post-herniorrhaphy achieving up to 98% improvement rates. Minimally invasive methods, including endoscopic or robotic-assisted s, reduce tissue trauma; for instance, employs small incisions for precise nerve clipping in treatment. Purpose-based categorizations align procedures with clinical goals, primarily for neuropathic or conditions, where peripheral neurectomy of trigeminal branches provides short- to medium-term in cases. Functional disablement targets symptom control, such as vestibular neurectomy to eliminate aberrant vestibular signals causing vertigo while preserving hearing in unilateral peripheral disorders. Autonomic modulation addresses dysregulations like through sympathectomy, which interrupts sympathetic chains to halt excessive glandular activity, with endoscopic variants yielding high success rates in primary cases. These classifications overlap in practice, allowing tailored selection based on patient and pathology.

History

Early Surgical Developments

The 19th century marked the introduction of neurectomy as a deliberate surgical intervention, primarily for , a debilitating condition. Peripheral neurectomies, involving the cutting of branches, were first attempted around 1830, with initial successes reported in alleviating tic douloureux symptoms through resection of supraorbital or infraorbital nerves. Systematic documentation and reviews of these procedures proliferated between 1869 and 1895, as surgeons refined techniques to target peripheral branches while minimizing complications like anesthesia dolorosa. By the late 1800s, more invasive approaches emerged, such as the 1856 trans-antral exposure of the by Murray Carnochan and the 1891 intradural sectioning of preganglionic rootlets by Victor Horsley, establishing neurectomy as a viable option for intractable when medical therapies failed. Early 20th-century milestones expanded neurectomy's applications beyond the face, with pioneering work in pelvic and vestibular domains. Presacral neurectomy, targeting sympathetic nerves for severe , gained traction in the 1930s at institutions like , where surgeons performed the procedure alongside dilatation and to interrupt pain transmission from the uterus; by 1946, 111 cases had been completed there, demonstrating moderate relief in select patients with primary or secondary . Concurrently, vestibular neurectomy for vertigo associated with Meniere's disease was advanced by Walter E. at , who began selective procedures via the suboccipital (retrosigmoid) approach in 1932 after initial total eighth nerve sections from 1924; by his death in 1946, had conducted 692 such operations, the largest series to date, achieving high rates of vertigo control while preserving hearing in many cases.

Advancements in the 20th and 21st Centuries

In the mid-20th century, vestibular neurectomy gained prominence through the extensive work of neurosurgeon , who performed 692 procedures between 1924 and 1946 primarily to treat vertigo associated with , achieving low mortality rates with only two fatalities attributed to infection. Building on such foundational efforts, singular neurectomy emerged as a targeted approach when Richard Gacek introduced the transection of the posterior ampullary nerve in 1974 specifically for managing intractable , offering a selective of the posterior semicircular canal to alleviate positional symptoms without broadly affecting vestibular function. The late 20th century marked a shift toward minimally invasive techniques, with laparoscopic presacral neurectomy introduced in the late 1980s and gaining traction in the as an alternative to open surgery for central and severe linked to conditions like . This approach reduced recovery times and complications compared to traditional methods, with early series reporting relief in over 70% of cases. Concurrently, emerged in the as a non-destructive technique for management, delivering short bursts of radiofrequency energy to nerves without causing full , thereby minimizing risks like neural damage while providing sustained relief for conditions such as . Entering the , robotic-assisted surgery enhanced precision in neurectomy procedures, particularly with the da Vinci system applied to presacral neurectomy since the 2010s, enabling three-dimensional visualization and improved maneuverability in the for better outcomes in chronic pelvic pain. Refinements in vidian neurectomy for refractory also advanced, with post-2020 endoscopic studies demonstrating 80-90% symptom relief in nasal hypersecretion and congestion among patients unresponsive to medical therapy, attributed to more accurate targeting via transnasal approaches.

Indications

In Humans

Neurectomy is indicated in humans for various chronic pain conditions, particularly those involving neuropathic mechanisms that are refractory to conservative treatments. In cases of chronic neuropathic pain, such as post-herniorrhaphy neuralgia, selective neurectomy targets the affected nerves to interrupt aberrant signaling and provide relief. For instance, ilioinguinal neurectomy has demonstrated significant pain reduction in patients with chronic groin pain following inguinal hernia repair, with studies reporting lower pain severity at multiple postoperative intervals compared to nerve preservation. Similarly, for trigeminal neuralgia, peripheral neurectomy of the trigeminal nerve branches offers a minimally invasive option, achieving pain control in a substantial proportion of patients unresponsive to medications, with success rates exceeding 80% in long-term follow-up for selected cases. Pelvic pain syndromes, including severe and endometriosis-related pain, represent another key indication where presacral neurectomy is employed to denervate pain pathways from the and surrounding structures. This procedure enhances cure rates when combined with conservative laparoscopic , particularly in women with midline , leading to over 70% reduction in symptoms in responsive patients. Nerve entrapment syndromes, such as intercostal or meralgia paresthetica involving the lateral femoral , also benefit from targeted neurectomy to alleviate localized ; for example, intercostal neurectomy has shown effectiveness in reducing chronic abdominal wall pain due to nerve impingement, with many patients experiencing substantial improvement. Beyond pain management, neurectomy addresses functional disorders like vertigo in , where vestibular neurectomy selectively ablates fibers to control disabling episodes while preserving hearing in most cases. Sympathetic neurectomy, often performed thoracoscopically, is a standard treatment for severe , effectively reducing excessive sweating in the palms, axillae, or face with success rates above 95% for primary refractory to medical therapy. Vidian neurectomy targets the vidian to treat vasomotor , providing long-term symptom relief in patients with intractable nasal hypersecretion and congestion unresponsive to other interventions. In addition, neurectomy serves as an option for refractory in the upper limbs, with hyperselective neurectomy—first described in and refined through modern protocols—focusing on specific motor branches to reduce without compromising voluntary . This approach yields durable improvements in for conditions like , enhancing limb positioning and daily activities in pediatric and adult patients. For chronic post-surgical pain, such as ilioinguinal after , neurectomy achieves 70-90% pain relief in carefully selected cases, underscoring its role in managing persistent neuropathic sequelae.

In Veterinary Medicine

In veterinary medicine, neurectomy is primarily employed to alleviate chronic pain and improve mobility in animals suffering from specific lameness conditions, particularly in equine and bovine species. One common application is the treatment of navicular syndrome, a frequent cause of caudal heel pain and lameness in horses, especially Quarter Horses, where palmar digital neurectomy (in forelimbs) or plantar digital neurectomy (in hindlimbs) severs the respective nerves to interrupt pain signals from the heel region. This salvage procedure is indicated when conservative management, such as shoeing adjustments or anti-inflammatory medications, fails to resolve the lameness associated with navicular bone pathology or deep digital flexor tendon issues. In a retrospective study of 50 horses with MRI-confirmed chronic foot pain treated with palmar or plantar digital neurectomy between 2005 and 2011, the procedure improved or resolved lameness in most cases, though 36% experienced postoperative complications, including residual lameness, painful neuromas, or early pain recurrence. Neurectomy also addresses neuromuscular disorders in , notably spastic in , a hereditary condition causing progressive spastic contractions of the and hindlimb hyperextension. Tibial neurectomy, which transects branches of the innervating the affected muscles, is a standard that preserves normal while targeting the hyperactive neural response, offering satisfactory long-term outcomes compared to . Since 2023, a modified tenectomy approach has emerged as a simpler surgical , involving partial resection to reduce spasms more accessibly and improve and performance without the full extent of traditional neurectomy risks. Additional indications include proximal suspensory desmitis in , where neurectomy of the deep branch of the is performed to relieve from or in the . This procedure targets the 's proximity to the suspensory origin, potentially reducing compartment pressure, but carries a risk of neurogenic in the proximal suspensory 's muscular portion, which could alter and predispose to further injury.

Surgical Procedures

Presacral Neurectomy

Presacral neurectomy is a surgical that interrupts the , a network of autonomic s located in the presacral space, to alleviate central by blocking sensory pathways from the and . The technique typically involves accessing the sacral through an incision below the , where the overlying the area is incised approximately 1 cm caudal to the to expose the . The fibers are then skeletonized using blunt and sharp , followed by , clipping, or excision of a segment of the to ensure complete transection while preserving adjacent structures like the middle sacral and presacral veins. The procedure can be performed via open, laparoscopic, or robotic approaches, each differing in invasiveness and recovery profile. Open presacral neurectomy requires a larger abdominal incision for direct access, typically resulting in a 4- to 6-week recovery period due to greater . In contrast, the laparoscopic approach uses multiple small incisions (e.g., umbilical and suprapubic ports) for and instrumentation, allowing for a shorter 2- to 4-week recovery with reduced postoperative pain and scarring. Robotic-assisted neurectomy, utilizing systems like the da Vinci platform, offers enhanced precision and three-dimensional visualization through similar port sites, often enabling same-day discharge and a recovery of about 2 weeks. A notable study involving 176 women (median age 30 years) combined laparoscopic presacral neurectomy with excision, demonstrating feasibility and safety in this minimally invasive format. This intervention is primarily indicated for severe or attributed to , particularly when conservative treatments fail and is midline-focused. relief occurs in 80% to 90% of patients, with studies reporting over 50% reduction in symptoms for 70% to 85% of cases depending on endometriosis stage. However, approximately 13% of patients may experience postoperative due to disruption of sympathetic innervation to the rectosigmoid, though this is often transient and manageable. Long-term efficacy emphasizes patient selection for central patterns to optimize outcomes.

Vestibular Neurectomy

Vestibular neurectomy involves the selective surgical severance of the vestibular portion of the (cranial nerve VIII) to eliminate vertigo symptoms while preserving the cochlear branch responsible for hearing. This targets the superior and inferior vestibular , which transmit balance signals from the , interrupting aberrant vestibular input without affecting auditory function. The technique requires precise identification and transection of the vestibular fibers within the internal auditory canal or at the , typically under microscopic guidance to avoid damage to adjacent structures like the or cochlear nerve. Common surgical approaches include the middle approach, which provides direct access to the superior through a ; the retrosigmoid approach, involving a suboccipital for exposure of the nerve bundle at the pontocerebellar angle; and the suboccipital approach, which offers broad visualization similar to the retrosigmoid but with variations in patient positioning for enhanced access. These methods allow for complete sectioning of vestibular afferents while minimizing risks to hearing preservation. Primarily applied in cases of or other forms of intractable peripheral vertigo unresponsive to conservative treatments, vestibular neurectomy effectively controls debilitating episodes by ablating the source of vestibular imbalance. Neurosurgeon Walter Dandy performed 692 such procedures between 1924 and 1946 at , reporting high success rates in vertigo resolution, which established the surgery as a standard intervention for the era. Variations include singular neurectomy, first described by Richard Gacek in 1974, which specifically targets the posterior ampullary nerve innervating the posterior semicircular canal to treat (BPPV) confined to that structure. Additionally, the endoscopic middle fossa approach enhances precision by using endoscopes for minimally invasive visualization and sectioning of the , reducing the need for extensive bone removal. As a less invasive alternative, can sometimes be considered for modulation without full sectioning.

Neurectomy for Nerve Entrapment

Neurectomy for nerve entrapment targets compressed peripheral sensory nerves, typically involving to release the nerve from surrounding or adhesions, followed by partial resection of the affected segment to alleviate while preserving motor function where possible. This approach addresses mechanical causing neuropathic symptoms, such as burning or tingling, and is reserved for cases to conservative treatments like or medications. The procedure minimizes disruption to larger nerve trunks by focusing on distal branches, reducing the risk of widespread . In cases of intercostal nerve entrapment leading to chronic thoracic pain, often post-thoracotomy or due to , surgical intervention combines with neurectomy of the intercostal cutaneous branches. Outcomes show substantial relief, with one study reporting an 84% success rate in reducing chronic postoperative pain in the thoracic region through targeted resection. Similarly, for meralgia paresthetica involving entrapment of the lateral femoral cutaneous nerve under the , neurectomy after initial yields high efficacy, with 94% of patients achieving significant symptom relief, though it may result in persistent numbness in the anterolateral . Ilioinguinal neurectomy addresses post-herniorrhaphy from nerve entrapment in , where partial resection follows to target neuromas. Long-term follow-up indicates complete or partial pain relief in approximately 67% of patients, though pain recurrence occurs in about 68% over an average of 35 months, highlighting the need for careful patient selection. For peripheral trigeminal branch entrapment causing , particularly in resource-limited rural settings, selective neurectomy of terminal branches like the infraorbital or supraorbital nerves provides effective palliation, with good outcomes in 65% of cases and suitability as a low-resource . These procedures are generally performed on an outpatient basis under , posing low risk especially for terminal sensory branches, and are often combined with to optimize gliding and prevent re-entrapment. ablation may serve as an adjunct in select cases to modulate pain transmission prior to resection.

Risks and Complications

General Risks

Neurectomy, as a surgical involving the intentional transection of a , carries inherent risks associated with interruption, alongside standard hazards. Common general surgical complications include at the incision site, excessive or hemorrhage, and adverse reactions to , such as respiratory depression or allergic responses. Direct consequences of often manifest as sensory disturbances, including numbness or loss of in the denervated area, which is an expected outcome but can lead to functional impairments or patient dissatisfaction. Painful formation, resulting from disorganized axonal regrowth at the proximal stump, is a known risk after transection. In peripheral neurectomies, incidence is typically 10–30% despite preventive techniques like burial, though higher rates (up to 60% for symptomatic cases) have been reported in contexts like limb amputations. This contributes to chronic triggered by mechanical stimuli. Additionally, anesthesia dolorosa—a severe deafferentation characterized by burning sensations in a numb region—is rare overall but arises in 0.2% to 4% of patients undergoing more extensive ablation procedures such as trigeminal , with lower incidence in targeted peripheral neurectomies. Interruption of nerves with autonomic components can result in systemic effects, such as dysregulation of visceral functions. For instance, presacral neurectomy has been associated with worsened or bladder dysfunction in approximately 19% of patients and in 12.5%, reflecting disrupted pelvic innervation, though these issues improve or remain stable in most cases. Risk profiles vary by indication: therapeutic neurectomies, performed to alleviate preoperative , carry a 35% chance of persistent or recurrent , potentially necessitating reoperation in 9% of cases, whereas prophylactic neurectomies—conducted intraoperatively to prevent future issues—exhibit low complication rates, with no reported postoperative in recent analyses.

Procedure-Specific Complications

Procedure-specific complications of neurectomy vary depending on the targeted and surgical approach, often involving disruption of adjacent neural or autonomic functions unique to the anatomical site. In presacral neurectomy, performed to alleviate chronic by severing sympathetic nerves near the sacral , patients may experience autonomic disturbances such as , which developed or worsened in 13% of cases in one study of 100 patients, urinary urgency in 3%, and painless first stage of labor in 2%. Vestibular neurectomy, aimed at controlling intractable vertigo by sectioning the vestibular portion of the eighth cranial nerve, carries risks to nearby structures in the , particularly with the retrosigmoid approach. Potential complications include due to cochlear nerve involvement, reported in up to 20% of cases with significant threshold shifts; persistent , which may not resolve if incomplete section occurs; residual in approximately 20% of patients from incomplete deafferentation; transient facial weakness or , occurring in 15% of cases and typically reversible; and (CSF) leak, with rates of 5-10% in retrosigmoid procedures, sometimes requiring reoperation. For neurectomy in nerve entrapment syndromes, such as meralgia paresthetica involving the lateral femoral cutaneous nerve, recurrence of entrapment symptoms can occur in about 15% of cases due to incomplete resection or neuroma formation at the proximal stump. In veterinary applications, analogous procedures like deep branch lateral plantar neurectomy in for proximal suspensory desmopathy risk iatrogenic damage to the , leading to adhesions or rupture in reported cases.

Pulsed Radiofrequency Ablation (as a Neurolytic Alternative)

, a minimally invasive using to disrupt nerve conduction without full transection, is sometimes considered an to traditional neurectomy. It has a lower complication profile than surgical methods, with transient affecting less than 5% of patients and resolving within weeks. However, unintended thermal injury to adjacent tissues remains a concern, potentially causing localized or if heat diffusion exceeds the target zone. As of 2023, emerging guidance like continue to reduce these risks.

Postoperative Care and Outcomes

Recovery Process

Immediate postoperative care following neurectomy in humans emphasizes , wound care, and monitoring for complications to promote healing and minimize risks like or formation. Analgesics such as acetaminophen, non-steroidal anti-inflammatory drugs (NSAIDs), or short-term are typically prescribed to control and , with approaches preferred to reduce opioid reliance. Patients are monitored for signs of , bleeding, or sensory changes, with particular attention to numbness in the denervated area, which requires protection to prevent inadvertent . Hospitalization duration varies by procedure and location. Peripheral neurectomies, such as those for or , are often performed outpatient or with a 1-day stay, allowing discharge once stable, with instructions for rest and elevation if applicable. More invasive procedures, like laparoscopic presacral neurectomy or vestibular neurectomy, may require 1-5 days of inpatient monitoring for neurological status and . For trigeminal peripheral neurectomy, follow-up visits are scheduled on postoperative days 2, 7, and 30, then every 6 months up to 3 years to assess pain relief and complications. Rehabilitation focuses on adapting to sensory deficits and restoring function. Physical therapy, including gentle exercises and gait training, may begin within days for ambulatory patients to prevent stiffness, particularly after lower extremity procedures. Patients are counseled on managing numbness, such as protective footwear for foot neurectomies to avoid ulcers. Recovery timelines typically range from 1-6 weeks for full return to normal activities, depending on the nerve targeted and surgical approach; for example, Morton's neuroma neurectomy allows partial weight-bearing immediately in a surgical shoe, with sutures removed at 2 weeks and full activity by 3 months. Follow-up includes clinical exams and, if needed, imaging to evaluate healing and detect neuromas early.

Long-Term Efficacy and Success Rates

Neurectomy procedures demonstrate variable long-term in providing sustained , typically ranging from 70% to 95% in carefully selected patients across different indications, though outcomes depend on the specific targeted and underlying . For instance, in cases of presacral neurectomy for endometriosis-related , more than 50% reduction in symptoms was reported in 74% of patients for overall , 61% for , and 55% for , with follow-up extending up to 72 months postoperatively. Similarly, vidian neurectomy for allergic or yields significant and durable improvements, with visual analog scale scores for nasal symptoms dropping from preoperative levels of approximately 7-8 to 2.6-3.7 at three years post-procedure, alongside enhanced quality-of-life metrics in domains such as and emotional . In , long-term reaches 80-90%, though up to 35% of patients may experience residual discomfort. These success rates highlight neurectomy's role in achieving substantial, multi-year symptom control when applied to appropriate candidates. Key factors influencing long-term durability include patient selection criteria, such as prior , ongoing use of medications, presence of paravertebral tender points, and response to diagnostic blocks, which can predict failure with odds ratios ranging from 1.8 to 3.7. Younger age has been associated with potentially higher recurrence risk in certain contexts, such as ilioinguinal neurectomy for post-herniorrhaphy , where overall recurrence approached 68% at a mean follow-up of 35 months, though complete or partial relief was achieved in 67% of cases, correlating with improved . Recurrence rates in therapeutic neurectomies generally fall between 20% and 35%, as seen in 23% of posterior neurectomies for at 58 months, often occurring after a median -free interval of 8 months. Prophylactic neurectomy, such as ilioinguinal excision during , lowers the incidence of chronic groin to 0-7.5% at six months compared to 10-22.5% with nerve preservation, based on 2022-2023 prospective data. Illustrative studies underscore these patterns; in human anterior neurectomy for chronic , approximately 50% achieved ≥50% relief at long-term follow-up, with higher success (61%) in recurrent versus ongoing pain cases. These findings emphasize the procedure's value in reducing over years while highlighting the need for diagnostic validation to optimize selection and mitigate recurrence.

Applications in

Use in Horses

Neurectomy in primarily involves palmar or plantar neurectomy, a surgical procedure targeting the palmar (forelimbs) or plantar (hindlimbs) nerves to alleviate chronic foot pain. This technique is most commonly applied to treat navicular disease or chronic heel pain that has not responded to conservative therapies such as shoeing modifications, anti-inflammatory medications, or corrective farriery. The procedure typically entails making a small incision over the region to expose and sever the nerves, often using the guillotine method where a 2-cm incision is made dorsal to the flexor tendons, the nerve is isolated, and a 1-2 cm segment is removed to prevent regeneration. Indications for palmar/plantar digital neurectomy are limited to cases of long-term lameness originating from the foot, particularly when (MRI) confirms lesions such as deep digital flexor damage or unresponsive to medical management. In a retrospective study of 50 treated between 2005 and 2011, the procedure was performed on animals with chronic foot pain verified by MRI, serving as a salvage option after failure of other interventions. This approach is considered a last-resort measure due to its irreversible nature and potential for complications, reserved for severe cases where is significantly impaired. Outcomes of the procedure show variable but often temporary relief, with 80% of in the aforementioned returning to previous athletic use for a duration of 20 months (range: 12-72 months), though 36% (18/50) experienced complications including residual lameness, painful , or early recurrence of . Broader reviews indicate that approximately 65-70% of achieve lameness resolution post-neurectomy, typically lasting 12-18 months before potential nerve regrowth or symptom return. A 2024 on 85 undergoing palmar digital neurectomy with dorsal-to-palmar branch neuroanastomosis to prevent found no reduction in neuroma formation, with 95% initial lameness resolution but only 68% remaining sound at 1 year and 22% complications. Risks include formation at the incision site, curb-like swellings from post-operative inflammation, and damage to the or deep digital flexor due to loss of sensation leading to self-trauma, emphasizing the need for strict stall rest and bandaging in the recovery period.

Use in Other Animals

In , peripheral neurectomy is employed in dogs to address and lameness associated with peripheral sheath tumors or injuries, where medical management proves refractory. For instance, ulnar neurectomy has been performed to excise neurofibromas in the carpal canal, resulting in of thoracic limb lameness without recurrence at 11 months postoperatively. Similarly, partial neurectomy for malignant peripheral sheath tumors enables limb-sparing , eliminating pain and lameness on long-term follow-up. These procedures often target sensory nerves, producing permanent desensitization of the affected area to alleviate ongoing discomfort. Non-selective cutaneous sensory neurectomy serves as an alternative for managing chronic self-mutilation lesions in dogs following , a complication driven by . Performed under general via a proximal incision to relevant sensory branches, the resolves self-trauma within 24 hours, with wounds healing uneventfully and no recurrence over periods up to 3 years. Such interventions are typically straightforward, allowing for outpatient recovery in suitable cases, though general is required. In , neurectomy addresses spastic paresis, a hereditary neuromuscular disorder causing hindlimb spasms and impaired mobility. Partial tibial neurectomy, which involves resecting a segment of the to denervate the gastrocnemius muscles, has been refined in recent applications, such as a 2023 case in a Simmental where a 1 cm nerve section was removed via a 15 cm incision, leading to immediate resolution of spasms and pain. This approach targets the underlying neuromuscular hyperactivity by denervating the affected muscles, restoring and enhancing welfare; alternative procedures like tenectomy address the tendons and may offer different advantages in access and risks. Outcomes for neurectomy in small animals like dogs demonstrate low complication rates, with case series reporting no postoperative issues such as neuroma formation in treated cohorts. In livestock, emerging applications for paresis yield high efficacy, with partial tibial neurectomy achieving good to excellent results in over 80% of cases, including 83% success in a study of 113 Belgian Blue calves where most exhibited normalized function without severe hyperflexion.

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