64712 Neuroplasty, major peripheral nerve, arm or leg, open; sciatic nerve

Name of the Procedure:

Neuroplasty, Major Peripheral Nerve, Arm or Leg, Open; Sciatic Nerve

Summary

This procedure involves surgically repairing or decompression of the sciatic nerve in the leg to relieve pain or restore function. The surgery is performed through an open incision to access the nerve directly.

Purpose

Neuroplasty for the sciatic nerve is performed to alleviate chronic pain, numbness, tingling, or weakness caused by nerve compression or injury. The goal is to restore normal nerve function and improve the patient's quality of life.

Indications

• Chronic sciatic nerve pain that does not respond to conservative treatments.
• Nerve compression due to injury, herniated disc, or scar tissue.
• Symptoms such as persistent numbness, tingling, or muscle weakness.
• Documented nerve conduction studies showing compromised nerve function.

Preparation

• Fasting for at least 8 hours before the surgery.
• Adjustments to current medications as instructed by the physician.
• Pre-operative diagnostic tests such as MRI or nerve conduction studies.
• Consultation with an anesthesiologist before the procedure.

Procedure Description

1. The patient is placed under general anesthesia.
2. A surgical incision is made over the area where the sciatic nerve is located.
3. The surgeon carefully exposes the sciatic nerve.
4. Scar tissue or other compressive structures are removed or released.
5. The nerve is inspected and repaired as needed.
6. The incision is closed with sutures or staples.
7. A sterile dressing is applied to the wound site.

Duration

The procedure typically takes about 2 to 3 hours.

Setting

Neuroplasty for the sciatic nerve is usually performed in a hospital operating room or a specialized surgical center.

Personnel

• Orthopedic surgeon or neurosurgeon
• Anesthesiologist
• Surgical nurses and assistants

Risks and Complications

• Infection at the surgical site
• Bleeding or hematoma formation
• Nerve damage leading to increased pain or weakness
• Scarring and formation of new adhesions
• Adverse reactions to anesthesia

Benefits

• Significant reduction or elimination of chronic sciatic pain
• Improved mobility and function of the affected leg
• Enhanced quality of life with the resolution of debilitating symptoms
• Benefits are often realized within a few weeks post-surgery as healing progresses.

Recovery

• Post-operative care includes wound monitoring and pain management.
• Physical therapy may be required to restore full function.
• Recovery time can vary from several weeks to a few months, depending on the extent of the surgery and the patient's overall health.
• Patients are advised to avoid heavy lifting or strenuous activities during recovery.
• Follow-up appointments to monitor progress and nerve healing.

Alternatives

• Conservative treatments such as physical therapy, medications, and steroid injections.
• Minimally invasive procedures like laparoscopic neuroplasty.
• In some cases, alternative nerve decompression techniques may be considered.
• Each alternative has its own set of pros and cons, including differing recovery times and success rates.

Patient Experience

• During the procedure, the patient will be under general anesthesia and will not feel pain.
• Post-operative pain and discomfort are managed with medications.
• Patients may experience some swelling, bruising, and pain at the incision site initially.
• Physical therapy and gradual return to activity help ensure a smooth recovery process.