64786 Excision of neuroma; sciatic nerve

Name of the Procedure:

Excision of Neuroma; Sciatic Nerve

Summary

In this procedure, a surgeon removes a neuroma (a painful nerve tumor) from the sciatic nerve. The surgery aims to alleviate pain, numbness, or other symptoms caused by the neuroma.

Purpose

Medical Condition:

A neuroma, a benign growth on the nerve that can cause pain, tingling, or numbness.

Goals/Outcomes:

Alleviate pain and improve the function of the affected limb by removing the neuroma.

Indications

Symptoms/Conditions:

• Persistent pain in the buttock, leg, or foot
• Numbness or tingling sensations
• Muscle weakness ##### Patient Criteria:
• Ineffectiveness of conservative treatments (e.g., medications, physical therapy)
• Confirmed diagnosis of a neuroma on the sciatic nerve via imaging studies

Preparation

Instructions:

• Fasting for at least 8 hours before the procedure
• Stopping certain medications (e.g., blood thinners) as advised by your doctor ##### Diagnostic Tests:
• MRI or CT scan to locate the neuroma
• Blood work and other pre-surgical assessments

Procedure Description

Steps:

1. Administration of general or regional anesthesia.
2. An incision is made near the location of the neuroma.
3. The surgeon carefully exposes the sciatic nerve and identifies the neuroma.
4. The neuroma is excised (removed) while preserving the healthy nerve tissue.
5. The incision is closed with sutures. ##### Tools/Equipment:
   • Surgical scalpel
   • Microsurgical instruments ##### Anesthesia: General anesthesia (patient is asleep) or regional anesthesia (patient is awake but numb from the waist down).

Duration

The procedure typically takes 1 to 2 hours.

Setting

• Hospital operating room or specialized surgical center

Personnel

• Orthopedic or neurosurgeon
• Anesthesiologist
• Surgical nurses
• Operating room technician

Risks and Complications

Common:

• Infection
• Bleeding ##### Rare:
• Persistent pain or numbness
• Nerve damage leading to muscle weakness
• Blood clots

Benefits

• Relief from pain and other symptoms caused by the neuroma
• Improved mobility and function of the affected limb
• Benefits may be realized within a few weeks after surgery

Recovery

Post-Procedure Care:

• Pain management with prescribed medications
• Wound care instructions to prevent infection
• Physical therapy to aid recovery ##### Expected Recovery Time:
• Initial recovery within 2-4 weeks
• Full recovery may take up to 3 months ##### Restrictions/Follow-Up:
• Avoid strenuous activities for several weeks
• Regular follow-up appointments to monitor healing

Alternatives

Other Treatment Options:

• Medications (e.g., anti-inflammatories, pain relievers)
• Physical therapy
• Corticosteroid injections ##### Pros/Cons of Alternatives:
• Medications and injections may provide temporary relief but do not remove the neuroma
• Physical therapy may alleviate symptoms but is not a definitive cure

Patient Experience

During the Procedure:

• Under general anesthesia, the patient will be completely unconscious and feel no pain.
• With regional anesthesia, the patient will be awake but feel no pain in the surgical area. ##### After the Procedure:
• Mild to moderate pain managed with medications
• Discomfort and swelling around the incision site
• Gradual improvement in symptoms over the recovery period