The Role of Surgery in Peripheral Neuropathy
Surgery may be necessary for certain underlying conditions that may be associated with peripheral neuropathy (PN). For example, if the neuropathy is caused by a condition such as carpal tunnel syndrome or the nerve compression is caused by a ruptured disk or a tumor, surgery may be necessary to resolve the underlying problem and relieve the neuropathic pain. Reconstructive surgery may be required for structural changes that may occur as neuropathy progresses (e.g., Achilles tendon lengthening).
Spinal Cord Stimulation
Spinal cord stimulation (SCS) is a treatment that delivers electrical stimulation to the dorsal column of the spinal cord through a surgically implanted electrode which is connected to an electrical stimulating device. SCS is usually reserved for treatment of pain in patients with neuropathic pain who have not responded to conventional treatment. Up to 70% of these patients have reported pain relief one year after initiating treatment with SCS. Spinal cord stimulation appears to be more effective for spontaneous pain than for other types (e.g. allodynia). Studies are being conducted investigating the addition of an intrathecal baclofen pump (medication delivered directly into the spinal fluid) to SCS for patients with various types of neuropathic pain who do not respond to SCS alone.