Peripheral Nerve Surgery

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Things you need to know

What is Peripheral Nerve Surgery?

Peripheral nerve surgery involves procedures to repair, decompress, or treat disorders of the peripheral nervous system (nerves outside the brain and spinal cord) to relieve pain, restore function, or improve sensation. It addresses conditions like nerve injuries, entrapments, or tumors affecting peripheral nerves. In India, peripheral nerve surgery is performed in neurosurgery or orthopedic surgery departments at hospitals like Apollo, Fortis, Medanta, and AIIMS, offering advanced care at affordable costs. Understanding the procedure, costs, recovery, risks, and frequently asked questions (FAQs) is essential for patients and families in India to make informed decisions.

Why do you need Peripheral Nerve Surgery?

Peripheral nerve surgery is indicated for:

Nerve injuries:
- Traumatic: Lacerations, stretch injuries, or fractures (e.g., brachial plexus injury from accidents).
- Iatrogenic: Nerve damage during surgery (e.g., radial nerve injury during humerus fracture repair).
Nerve entrapment syndromes:
- Carpal tunnel syndrome (median nerve compression at the wrist).
- Cubital tunnel syndrome (ulnar nerve compression at the elbow).
- Peroneal nerve entrapment (foot drop from compression at the knee).
Peripheral nerve tumors:
- Benign: Schwannomas, neurofibromas (often linked to neurofibromatosis).
- Malignant: Rare, like malignant peripheral nerve sheath tumors (MPNSTs).
Neuropathic pain: Post-traumatic or post-surgical nerve pain (e.g., neuroma formation).
Chronic conditions: Nerve damage from diabetes, infections, or toxins causing weakness or sensory loss.

The procedure aims to relieve compression, repair nerve damage, remove tumors, or manage pain, improving function and quality of life.

Why Do Peripheral Nerve Surgery Costs Vary in India?

Costs range from ₹50,000 to ₹3 lakh:

Procedure Type: Carpal tunnel release (₹50,000–₹1 lakh); nerve repair/grafting or tumor resection (₹1–3 lakh).
Hospital/Location: Higher in metro cities (Apollo, Fortis); lower in government hospitals (AIIMS, ₹20,000–₹80,000).
Surgeon’s Expertise: Experienced neurosurgeons or hand surgeons charge more.
Additional Costs: EMG/NCS (₹5,000–₹15,000), MRI (₹5,000–₹15,000), hospital stay, physiotherapy.
Insurance: Covered for symptomatic entrapments, injuries, or tumors; Ayushman Bharat offers subsidies.

Peripheral Nerve Surgery Procedure

Before Surgery Evaluation:
- Diagnosis:
  - Electromyography (EMG) and nerve conduction studies (NCS): Confirm nerve injury, location, and severity.
  - MRI or ultrasound: Visualizes nerve tumors, neuromas, or entrapment sites.
  - Clinical exam: Assesses motor (e.g., weakness) and sensory deficits (e.g., numbness, tingling).
  - Blood tests: Rule out systemic causes (e.g., diabetes, vitamin B12 deficiency).
- Medications: Pain relief (e.g., gabapentin for neuropathic pain); anti-inflammatories for entrapment.
- Consent: Risks, including incomplete recovery, are explained.
Surgical Techniques:
- Nerve Decompression:
  - Carpal Tunnel Release:
    - Performed under local anesthesia, lasting 15–30 minutes.
    - A 2–3 cm incision is made at the wrist.
    - The transverse carpal ligament is cut to relieve median nerve compression.
    - The incision is closed with sutures.
  - Cubital Tunnel Release:
    - A 3–5 cm incision at the elbow; the ulnar nerve is decompressed by releasing constricting tissues.
- Nerve Repair (Neurorrhaphy):
  - For traumatic nerve cuts, lasting 1–3 hours.
  - Under general anesthesia, the nerve ends are identified, cleaned, and sutured together (end-to-end repair) using microsurgery.
  - If a gap exists, a nerve graft (e.g., from the sural nerve in the leg) bridges the defect.
- Nerve Tumor Resection:
  - For schwannomas/neurofibromas, lasting 1–3 hours.
  - A small incision over the tumor; the tumor is carefully dissected from the nerve using a microscope to preserve nerve function.
  - Malignant tumors may require wider resection, sometimes sacrificing the nerve.
- Neurolysis:
  - For scar tissue or adhesions around a nerve (e.g., post-trauma), the nerve is freed to restore function.
- Intraoperative Tools:
  - Microscope: Enhances precision in nerve handling.
  - Nerve stimulator: Confirms nerve function during surgery.
  - EMG/NCS: Intraoperative monitoring to assess nerve response.
After Surgery:
- Ward monitoring for 1–2 days; hospital stay of 0–2 days (outpatient for decompression).
- Pain management: Analgesics (e.g., paracetamol) for 1–2 weeks.
- Splinting: Wrist splint (carpal tunnel, 1–2 weeks); arm/leg splint (nerve repair, 3–6 weeks) to protect the nerve.
- Physical therapy: Starts at 2–4 weeks to restore strength and mobility.
- Follow-up EMG/NCS: At 3–6 months to monitor nerve recovery.

Recovery After Peripheral Nerve Surgery

Hospital Stay: 0–2 days (outpatient for decompression; 1–2 days for nerve repair/tumor resection).
Post-Surgery Care:
- Pain: Incision discomfort for 1–2 weeks; neuropathic pain may improve over months.
- Activity: Light use of the limb immediately (decompression); restricted movement for 3–6 weeks (nerve repair).
- Splinting: Protects the nerve during healing (e.g., wrist splint for carpal tunnel).
- Physical therapy: Starts at 2–4 weeks; focuses on range of motion, strength, and desensitization (if numbness persists).
- Sensation/motor recovery: Slow (1 mm/day nerve regeneration); may take 3–12 months depending on injury severity and distance to target muscle.
Diet: Normal diet; high-protein foods (e.g., eggs, lentils) support healing; 2–3 liters water daily.
Follow-Up:
- Visits at 2 weeks, 6 weeks, and 3–6 months; EMG/NCS at 3–6 months.
- Monitor for functional improvement (e.g., grip strength, sensation).

Recovery varies: Decompression (e.g., carpal tunnel) sees 80–90% symptom relief in 6–12 weeks; nerve repair recovery takes 6–12 months, with 60–80% functional recovery depending on injury severity. Tumor resection success: 90% for benign tumors with preserved nerve function.

Risks and Complications

Surgical Risks: Bleeding (1–2%), infection (1–3%), scar tenderness (2–5%).
Neurological Complications:
- Incomplete recovery (10–30% in nerve repair): Due to delayed surgery, long gaps, or severe damage.
- Worsening symptoms (1–3%): Temporary or permanent numbness/weakness.
- Neuroma formation (2–5%): Painful nerve scarring, may require further surgery.
Tumor-Specific: Recurrence (5–10% for benign tumors; higher for malignant); nerve sacrifice (malignant, 10–20%).
General Risks: Anesthesia reactions, delayed wound healing.
Long-Term: Chronic pain (2–5%), limited functional recovery (esp. in older patients or delayed repairs).

Report fever, severe pain, or worsening symptoms promptly.

Frequently Asked Questions (FAQs)

What causes peripheral nerve issues?

Trauma, repetitive strain (e.g., carpal tunnel), tumors, diabetes, or iatrogenic injury (surgery-related).

Can nerve damage heal without surgery?

Mild entrapments may improve with rest, physiotherapy, or injections (e.g., 50–70% of carpal tunnel cases); severe injuries or tumors often require surgery.

Will I regain full function?

Decompression: 80–90% success; nerve repair: 60–80% recovery, depending on timing and injury severity.

How soon can I resume activities?

Decompression: 2–4 weeks; nerve repair: 6–12 weeks for light activities, full recovery in 6–12 months.

Is peripheral nerve surgery covered by insurance in India?

Yes, for symptomatic conditions; confirm with your provider.

Signs of complications?

Fever, severe pain, swelling, or worsening numbness/weakness.

Can nerve damage recur?

Yes, entrapment can recur (5–10%) if risk factors (e.g., repetitive strain) persist; tumors may recur (5–10%).

Lifestyle changes post-surgery?

Avoid repetitive strain, use splints as advised, continue physiotherapy, and follow up regularly.

Conclusion

Peripheral nerve surgery effectively addresses nerve injuries, entrapments, and tumors, with high success rates for symptom relief and functional restoration. India’s top hospitals (Apollo, Fortis, AIIMS) offer affordable, expert care. Understanding the procedure, costs, recovery, risks, and FAQs helps patients approach surgery confidently. Consult a neurosurgeon or hand surgeon for personalized guidance and optimal outcomes.

Looking for Best Hospitals for Peripheral nerve surgery

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we are not promoting any hospitals we sourced all the details from google and hospitals website, please verify and start with your surgery here we go the list includes government, budget and superspeciality hospitals accreditation bodies are the National Accreditation Board for Hospitals and Healthcare Providers (NABH) and the Joint Commission International (JCI)

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City	Minimum Price (₹)	Maximum Price (₹)
Agra	1,00,000	3,25,000
Ahmedabad	1,25,000	3,50,000
Ajmer	1,00,000	3,25,000
Aligarh	1,00,000	3,25,000
Allahabad	1,00,000	3,25,000
Amritsar	1,10,000	3,35,000
Aurangabad	1,10,000	3,35,000
Bangalore	1,25,000	3,50,000
Bareilly	1,00,000	3,25,000
Belgaum	1,10,000	3,35,000
Bhopal	1,10,000	3,35,000
Bhubaneswar	1,10,000	3,35,000
Bikaner	1,00,000	3,25,000
Chandigarh	1,25,000	3,50,000
Chennai	1,25,000	3,50,000
Coimbatore	1,25,000	3,50,000
Dehradun	1,10,000	3,35,000
Delhi	1,25,000	3,50,000
Dhanbad	1,00,000	3,25,000
Durgapur	1,00,000	3,25,000
Faridabad	1,25,000	3,50,000
Ghaziabad	1,25,000	3,50,000
Gorakhpur	1,00,000	3,25,000
Guntur	1,10,000	3,35,000
Gurgaon	1,25,000	3,50,000
Guwahati	1,10,000	3,35,000
Gwalior	1,00,000	3,25,000
Hyderabad	1,25,000	3,50,000
Indore	1,10,000	3,35,000
Jabalpur	1,00,000	3,25,000
Jaipur	1,25,000	3,50,000
Jalandhar	1,10,000	3,35,000
Jamshedpur	1,10,000	3,35,000
Jodhpur	1,00,000	3,25,000
Kanpur	1,00,000	3,25,000
Kochi	1,25,000	3,50,000
Kolkata	1,25,000	3,50,000
Kollam	1,10,000	3,35,000
Lucknow	1,10,000	3,35,000
Ludhiana	1,25,000	3,50,000
Madurai	1,10,000	3,35,000
Mangalore	1,10,000	3,35,000
Meerut	1,00,000	3,25,000
Moradabad	1,00,000	3,25,000
Mumbai	1,25,000	3,50,000
Mysore	1,25,000	3,50,000
Nagpur	1,10,000	3,35,000
Nashik	1,10,000	3,35,000
Navi Mumbai	1,25,000	3,50,000
Noida	1,25,000	3,50,000
Patna	1,00,000	3,25,000
Pune	1,25,000	3,50,000
Raipur	1,10,000	3,35,000
Rajkot	1,10,000	3,35,000
Ranchi	1,00,000	3,25,000
Surat	1,25,000	3,50,000
Thane	1,25,000	3,50,000
Vadodara	1,10,000	3,35,000
Varanasi	1,00,000	3,25,000
Visakhapatnam	1,10,000	3,35,000

Disclaimer

This information is sourced from open platforms and is for general awareness only. Costs may vary based on individual cases. Please consult a qualified doctor for medical advice and explore options within your budget before deciding on the procedure.