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Entries in Nerves (2)

Friday
Aug032012

Rare Spinal Surgery Cuts Chronic Pain for Wounded Marine

Jupiterimages/Thinkstock(BETHESDA, Md.) -- Mark Burleson awoke to unimaginable pain a month after the bomb he had been disarming detonated in his hands.

"My injuries were extensive, to say the least," said the 31-year-old Marine staff sergeant, who had severe burns, shattered bones and a brain injury from the December 2011 blast in Afghanistan's Helmand province.

Burleson's right arm was gone below the elbow; his left arm spared but paralyzed.

"All the nerves were ripped from my spinal cord at the root," he said, describing the damage that drove waves of pain down the otherwise senseless and limp limb.  "It felt like someone was lighting my arm on fire with a cutting torch.  And, occasionally, they'd stop and tie anchors to the ends of my fingers to rip out the bones."

Powerful drugs were no match for Burleson's constant agony.  And despite coming home from a war zone, the married father of three felt world's away.

"It was to the point where the kids would just walk past him because they know he couldn't bear to interact with them," said Burleson's wife, Sara.  "He became like a ghost."

Willing to try anything for relief, Burleson was quick to sign up for risky surgery to slice open his spine and singe the offending nerves.

"The pain was ripping our lives apart," the Camp Lejeune, N.C.-based Marine said.  "This was our last-ditch effort at having a normal life."

On July 26, Burleson left Walter Reed Army Medical Center in Bethesda, Md., for Johns Hopkins Hospital in Baltimore, where neurosurgeon Dr. Allan Belzberg agreed to try the high-stakes, high-risk surgery.

"It's a dangerous operation, so we only use it when we've exhausted all other options," said Belzberg, who performs the procedure three or four times a year.

Using a microscope and a tiny electrode, Belzberg made 140 burns in the damaged nerves dangling from Burleson's spinal cord; nerves intermixed with healthy connections to his lower limbs.

"If you get it just right, you get rid of the pain," Belzberg said of the stressful six-hour procedure.  "If you're the slightest bit off, you paralyze his leg."

But the surgery went smoothly.  And one week later, Burleson is a new man, although he expects to be at Walter Reed for at least a year.

"It was like instant clarity," Burleson said.

Sara Burleson, who spoke to her husband by phone before he returned to Walter Reed on Tuesday, said, "I could tell even before I saw him that it had worked.  His voice sounded lighter.  Even though he was groggy from the surgery, this huge weight had been lifted."

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Copyright 2012 ABC News Radio

Tuesday
May152012

Quadriplegic Moves Fingers After Nerve-Stealing Surgery

Washington University School of Medicine in St. Louis(ST. LOUIS) -- A 71-year-old quadriplegic man can move his fingers after surgeons "stole" healthy nerves from his arm and rerouted them to his hand, according to a new case study.

The man, whose name has not been released, crushed his spinal cord at the C7 vertebrae in the base of his neck in a 2008 motor vehicle accident.  The injury severed the nerve circuits that would send signals from his brain to the muscles in his hands, but it spared nearby nerves that could be coaxed into taking over.

"It's called nerve transfer surgery," said Dr. Ida Fox, assistant professor of plastic and reconstructive surgery at Washington University in St. Louis.  "It's borrowing a nerve that's still working and displacing it into a nerve that isn't working."

People with C7 spinal cord injuries can't move their hands, but they can move their shoulders, elbows and wrists, thanks to nerves that originate above the injury.  To tap into those healthy circuits, Fox and colleagues cut the nerve that controlled the man's brachialis, an arm muscle that helps bend the elbow.  They then attached it to the non-working nerve projecting out to his hand with a tiny stitch the size of a hair.

"We had to sacrifice something that's 'sacrificable,'" said Fox, describing how the biceps and other elbow-bending muscles would pick up the brachialis' slack.

Over six months, the nerve, which is no thicker than a strand of angel hair pasta, grew six inches along the old non-working nerve, reaching the hand muscles at the end.  And with intense physical therapy, the man learned to move his fingers with the nerve that once bent his arm.

"The brain has to be trained to think, 'OK, I used to bend my elbow with this nerve, and now I use it to pinch,'" said Fox.  "We're not changing any of the biomechanics; we're just changing the wiring.  So it's more of a mental game that patients have to play with themselves."

The case study, published Tuesday in the Journal of Neurosurgery, could give surgeons a tricky tool to help spinal cord injury patients hold onto some independence, Fox said.

"These patients have figured out very clever adaptive strategies to get around the fact that their hands don't do what they want them to do.  But they want to be able to do things more quickly without help," said Fox, adding that patients frequently say they wish they could eat without assistive devices.  "This makes stealing that brachialis muscle worth it."

One year after the procedure, the man is able to feed himself bite-size pieces of food.

Copyright 2012 ABC News Radio







ABC News Radio