Traditional techniques for the surgical management of symptomatic neuromas involve excision with intra-muscular or intra-osseous burying. Over the last decade, a number of novel strategies have been developed that have led to a resurgence of interest in management of the symptomatic neuroma. These techniques are collectively summarized as active management strategies and include targeted muscle reinnervation (TMR), regenerative peripheral nerve interface (RPNI) and others.
This comprehensive text provides a deep dive into the contemporary management of symptomatic neuromas. It discusses the diagnostic workup for neuropathic pain, including the use of imaging and diagnostic nerve blocks, and reviews the epidemiology and demographics of patients presenting with this problem. It then explores non-surgical modalities, as well as both traditional and novel surgical techniques, for the management of symptomatic neuroma. Part of the book is case-based and highlights these techniques, and can serve as a full-color atlas for the peripheral nerve surgeon.
Contemporary Neuroma Management presents a concentrated, modern approach to the management of neuromas and will be utilized by peripheral nerve surgeons (plastic surgeons, neurosurgeons, orthopedic surgeons) as well as other pain management providers.
Definition, Etiology, and Epidemiology of Symptomatic Neuroma.-
Peripheral Sensitization: Peripheral Mechanisms of Neuroma and Neuropathic
Pain.- Central Sensitization: Central Mechanisms of Neuroma and Neuropathic
Pain.- Clinical Diagnosis of Symptomatic Neuroma.- The Role of Diagnostic
Nerve Blocks in the Diagnosis of Neuroma.- Radiologic Imaging of Neuroma.-
Neuroma Pathology: The Role of Histologic Analysis.- Pharmacotherapy and
Medical Management for Neuroma and Neuropathic Pain.- Physical/Occupational
Therapy and Desensitization Techniques for Neuroma.- Interventional Pain
Management for Neuromas: Non-Surgical Ablative Techniques.- Neuromodulation
for Painful Neuromas.- Psychosocial Aspects of Neuroma
Management.- Interdisciplinary Surgical Decision Making for Painful Neuroma.-
Neuroma-in-Continuity Preoperative and Intraoperative Assessment.- Surgical
Treatment of Neuroma-in-Continuity.- Intramuscular, Intra-osseous, and
Intravenous Implantation of Nerve in Treatment of Painful Peripheral
Neuroma.- Targeted Muscle Reinnervation for Treatment of Symptomatic
Neuroma.- Regenerative Peripheral Nerve Interfaces for Treatment of
Symptomatic Neuroma.- Other Surgical Techniques for Treatment of Neuroma:
Relocation Nerve Grafting, Centro-central Neurorrhaphy, Nerve Cap,
End-to-side neurorrhaphy.- Head and Neck Neuroma Cases.- Upper Extremity
Neuroma Cases.- Upper Extremity Amputee Neuroma Cases.- Trunk Neuroma Cases:
Thorax, Groin, and Pelvis.- Lower Extremity Neuroma Cases.- Lower Extremity
Amputee Neuroma Cases.- Scientific Pursuit of Neuroma Management.- Future
Directions in Neuroma Management.
Kyle R. Eberlin, MD, Division of Plastic and Reconstructive Surgery, Department of Surgery, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA
Ivica Ducic, MD, PhD, Washington Nerve Institute, McLean, VA, USA
Amy Moore, MD, Department of Plastic and Reconstructive Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA
Paul S. Cederna, MD, Section of Plastic Surgery, Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
Ian Valerio, MD, Division of Plastic and Reconstructive Surgery, Department of Surgery, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA
Gregory A. Dumanian, MD, Division of Plastic Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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