Nerve teasing preparations
CPT4 code
Name of the Procedure:
Nerve Teasing Preparations
Summary
Nerve teasing preparations involve the meticulous dissection and isolation of individual nerve fibers from a nerve bundle. This is typically performed under a microscope to study the fine structure of nerves.
Purpose
This procedure addresses conditions requiring detailed analysis of nerve fiber structure and function, such as nerve damage or degeneration. The goal is to obtain high-quality samples for microscopic examination to inform diagnosis or research.
Indications
- Diagnosis of peripheral neuropathies and other nerve disorders.
- Research on nerve regeneration and repair.
- Conditions needing assessment of nerve fiber integrity, like traumatic nerve injury.
Preparation
- No special fasting or dietary restrictions.
- Review of the patient's medical history and any current medications.
- Pre-procedure diagnostic tests, such as nerve conduction studies or imaging, may be required.
Procedure Description
- The area containing the nerve is sterilized and anesthetized.
- A small incision is made to expose the nerve bundle.
- Under a microscope, individual nerve fibers are meticulously isolated and extracted using fine tools.
The extracted fibers are preserved for further microscopic or biochemical analysis.
Tools: Microscopes, fine dissection instruments Anesthesia: Local anesthesia is typically used.
Duration
The procedure usually takes 1-2 hours, depending on the complexity and number of fibers being isolated.
Setting
Performed in a specialized clinic or hospital setting with the necessary microsurgical equipment.
Personnel
- Surgeon or neurologist specialized in microsurgery
- Surgical nurse or assistant
- Anesthesiologist or nurse anesthetist (for anesthesia administration)
Risks and Complications
- Common: Minor bleeding, infection at the incision site.
- Rare: Nerve damage, prolonged numbness or pain at the site. Complications are managed through antibiotics for infections and analgesics for pain.
Benefits
Provides accurate, detailed information on nerve fiber structure, aiding in precise diagnosis and informing targeted treatment plans. Benefits can be realized immediately upon microscopic examination of the samples.
Recovery
- Post-procedure monitoring for a few hours.
- Keep the incision site clean and dry.
- Pain management with over-the-counter analgesics.
- Follow-up visits to monitor healing and discuss findings. Expected recovery time: 1-2 weeks.
Alternatives
- Nerve biopsy: Involves taking a small sample of nerve tissue but is less focused on individual fibers.
Electromyography (EMG): Measures electrical activity in muscles but provides less detailed structural information.
Pros of nerve teasing:
- Higher resolution information on nerve fibers. Cons of alternatives:
- Less detailed, less specific information.
Patient Experience
During the procedure: Minimal discomfort due to local anesthesia. After the procedure: Mild pain or discomfort at the incision site, manageable with pain relief measures. Full recovery within a week or two with proper care.