What is Neurolysis?
The term neurolysis almost exclusively means treatment of pain via destruction of a nerve responsible for it. This may have applications in the treatment of several diseases, including chronic pain illnesses in the extremities. However, it is most often used as means to control pain for people with cancer. Even in these instances, development of more successful nerve block techniques where a nerve is only temporarily disabled may be preferred.
There are several different way that neurolysis can be performed. One of the most common methods is to inject a chemical into the nerve that will kill it, and the chemical that may be used the most is alcohol. Injections may need to be repeated several times so that the nerve is fully stripped of its ability to function. Heat or radiofrequency can be used to kill nerves too, and in extreme scenarios a nerve can be removed via surgery. The chemical form of neurolysis is often preferred because it is the simplest, and most patients easily tolerate the procedure.
Some chronic pain clinics offer neurolysis for other conditions, especially chronic pain conditions that appear to have no cure or no definable origin. Use of this procedure in any of its forms in a manner that is more experimental may not always be something health insurance companies will support. If a patient suffering from a chronic pain condition is given the suggestion of using this tactic, they should inquire about the likelihood of an insurance company reimbursing for it. When the disorder treated is from cancer, surgeries, injections or other means of destroying a nerve are generally viewed as quite standard, and thus coverable.
Destruction of a nerve, while it can relieve pain, may also have some side effects. Especially if neurolysis occurs near the spine, there is a small risk of paralysis, in the area supplied by the nerve or elsewhere. This risk is thought fairly low-risk provided an experience doctor is performing the procedure. Nevertheless, it needs to be stated that the procedure is not without risk.
There are some alternatives to neurolysis that have become increasingly acceptable. One of these is temporarily blocking function of a nerve through anesthesia, in procedures that are called nerve blocks. This does mean more medication may need to be delivered to the body to continue pain control, but some people prefer this to damaging a nerve forever or for a very long time.
Yesterday I operated on a patient who had severe pain and electric current-like sensations in the distal limb beyond the knee joint. I was suspecting entrapment of the peroneal nerve at knee level, as he had undergone a biopsy procedure at the same site and had a scar. A biopsy was done for confirmation of chondromatosis knee joint, which he still has. Now after about 24 hours, he is complaining of severe pain and all other symptoms. What should I do now?
I think I'd rather have a nerve blocker operation than neurolysis, which in addition to being permanent sounds very risky to me for complications. Injecting a chemical into a nerve to kill it would be very dangerous, in my opinion.
Post your comments