American Society for Peripheral Nerve
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Evaluating the Impact of Lower Extremity Nerve Decompressions on Quality of Life and Pain
Mehak Chawla, MBA1; Julie M West, MS, PA-C2; Andrew L. O'Brien, MD, MPH2; Tiam M Saffari, MD, PhD, MSc2; Moore M Amy, MD3
1The Ohio State University College of Medicine, Columbus, OH; 2The Ohio State University Wexner Medical Center, Columbus, OH; 3Division of Plastic and Reconstructive Surgery, The Ohio State University Wexner Medical Center, Columbus, OH

Introduction: Proximal nerve injuries can cause nerve swelling which can lead to distal nerve compression syndromes that are a source of chronic pain for patients. The aim of this study was to evaluate the surgical characteristics, safety, and effectiveness of lower extremity nerve decompressions for the treatment of pain.
Materials and Methods: In this retrospective chart review, data from medical records of patients aged ?18 years who had lower extremity nerve decompressions from June 2020 to April 2022 were reviewed. Demographic data, etiology of injuries, surgical complications and follow-up times were recorded. The visual analog scale (VAS) was used to quantify patient-reported pain, depression scores, and quality of life both pre- and post-operatively.
Results: A total of 32 patients (62.5% females, 37.5% males, average age of 47.6 years) who underwent lower extremity nerve decompressions for the treatment of pain were identified up to one year of follow-up. One patient was lost to post-operative follow-up. Nerve injuries were caused by trauma (34%), idiopathic compression (28%), iatrogenic causes (25%), and tumors (13%). Patients were referred through orthopedic surgery (52%), self (13%), plastic surgery (10%) and neurology (10%). Postoperatively, four patients (13%) experienced minor complications (n=2 cellulitis, n=2 wound dehiscence) that did not require readmission; no major complications occurred. Average follow-up time from date of nerve surgery to most recent follow-up was 5.4 (± 5.6) months. The nerves involved in decompressions include peroneal (43%), femoral (14%) and tibial (6%) nerves, respectively. Most surgeries were performed as outpatient procedures (n=29).
Average pain significantly decreased at three-months postoperatively (mean difference=2.1, p=0.003, n=9) compared to preoperatively. The impact of pain on depression, frustration, and quality of life significantly decreased at 1-2 weeks postoperative follow-up (p=0.04, p=0.02, p=0.01 respectively, n=11), (Table 1). The proportion of patients using opioids and non-steroidal anti-inflammatory drugs decreased over the course of three months postoperatively compared to preoperative use.
Conclusions: Lower extremity nerve decompressions are safe and effective ways to treat pain associated with peripheral nerve injury of varying etiologies. Decompression of known entrapment sites in the lower extremity significantly decreased pain and reduced opioid usage over time, both of which had a positive impact on patient’s quality of life. Future studies are needed to evaluate pain during long-term follow-up.


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