Nerve surgery

What is nerve surgery?

Nerve surgery mends a nerve that's been damaged or severed, joining it back up so it can regrow over time and bring back feeling or movement to whatever part of the body it serves.

What conditions does nerve surgery treat?

Damage to a nerve generally comes from either a cut or a crushing injury. Crushed but still intact, a nerve might leave you with some numbness that settles by itself given a few weeks, no operation needed. Once it's actually severed though, the affected area loses feeling altogether, and only surgery can bring the two pieces back into contact.

Injuries and previous operations are the most frequent culprits behind nerve damage.

What are the benefits of nerve surgery?

The goal is bringing back sensation and movement to whichever part of the body the damaged nerve serves, while also easing any pain that's come from the injury itself.

Are there different techniques used in nerve surgery?

• Direct repair, joining the two cut ends together with stitches placed under a microscope.
• Grafting, where a section too damaged to save gets removed and swapped for a length of nerve borrowed from elsewhere in your own body, or occasionally sourced from a donor, to close the space.
• Nerve transfer, redirecting a healthy nerve from close by so it picks up the damaged one's job instead, bringing function back sooner, though this can leave the area that donor nerve used to control with some reduced ability of its own.

What happens before nerve surgery?

This type of repair counts as urgent, so a slot gets arranged for you without much delay. Bear in mind the exact timing can still shift at short notice if someone else needs emergency treatment first, so it helps to bring along something to occupy yourself with in the meantime.

What happens during nerve surgery?

1. Your surgeon opens the wound, sometimes extending it, to locate both ends of the damaged nerve.
2. Working under a microscope, they trim away any damaged tissue from each nerve ending.
3. The endings are stitched together with extremely fine sutures, or, where a section is missing altogether, a graft bridges the space instead.
4. The wound is then closed up.

You're fully asleep throughout, thanks to a general anaesthetic.

What does recovery look like?

Joining the nerve back together doesn't restore sensation instantly. It first needs to grow its way back along its original path, meaning feeling returns bit by bit, and can take several months before it's fully back.

Roughly 3 weeks after the operation, physiotherapy exercises usually begin to help function along, sometimes combined with a form of electrical stimulation, with intensity building gradually as your recovery progresses.

A follow-up appointment typically takes place about a week afterwards, often bringing together a dressing check with a hand therapy session.

What are the risks and complications?

Possible risks and limitations of nerve surgery include:

• sensation or movement not returning in full, even where the operation itself has gone well
• with nerve transfer specifically, a degree of reduced function where the donor nerve used to work
• the standard risks that come with having any operation under a full general anaesthetic.