Targeted Muscle Reinnervation (TMR) is a type of repair therapy used on patients having amputated limbs or painful neuromas followed by nerve damage. When a nerve is severed, it tries to regrow, leading to a disordered mass of nerve tissue, which when lacks a defined target to regenerate towards, is known as a neuroma. TMR surgery involves using microsurgical procedures to redirect severed nerves to new muscle targets, which provides the nerve endings with a new muscle to innervate. This promotes the nerve to renew in an organized manner instead of a disorganized regeneration which could lead to painful neuromas.
How Does it Work?
The injured nerve is redirected to a neighboring muscle connecting its nerve endings during a tmr surgery. The damaged nerve is secured to an adjacent healthy muscle’s nerve endings with the help of sutures and adhesives. This way, the damaged nerve is efficiently tricked into communicating with the new muscle instead of sending pain signals to the brain and spinal cord by regenerating in a disorganized manner.
What is the Recovery Period for a TMR Surgery?
Under general anesthesia, TMR procedures may take hours to complete. The surgical site is usually covered with a thick dressing to shield the nerve connections from any movement. Most patients who have undergone such surgeries may require only one overnight stay at the hospital, and they are discharged after prescribing some basic painkillers and a brief course of opioids.
Patients are advised to keep the heavy dressing on till three weeks after the surgery, following which they can remove them and begin simple exercises to regain normal movement. Complete activity and movement can be achieved within 12 weeks of the surgery. Some people might experience rapid relief, while for others it can be a gradual process, stretching over a period of several months, depending upon the length, severity, and mechanism of the nerve damage.
There might be some risks associated with surgery of a complex nature, like the presence of blood clotting, infections if the operated areas are not in a prime hygienic condition, complications from administration of anesthesia as well as excessive bleeding and pain.
TMR Surgery is Effective for Which Conditions?
TMR is helpful in preventing Phantom Limb Pain as well as managing chronic pain and abdominal wall pain, residual limb pain affecting prosthetic usage, and painful tissue scarring (neuromas).
Patients suffering from brachial plexus injuries, spinal cord injuries, or those who are generally too ill for surgery cannot receive treatment with Magnetic Resonance Imaging. Surgical risks are present with the process, and as a nerve repair therapy, patients could temporarily feel more pain.
Patients undergoing tmr surgery can achieve new degrees of functional mobility with prosthetic devices and an enhanced quality of life. In most cases, patients are frequently seen to have gained the ability to take up most of their pre-amputation activities, even with an arduous journey toward recovery. Additionally, it can be applied to enhance a person’s use and control over their prosthesis devices, making their lifestyle significantly easier.