Targeted Muscle Reinnervation

Combatting Pain

Targeted muscle reinnervation is a surgical technique that transfers the cut end of a nerve into a nearby redundant motor nerve of a muscle.

The two primary indications are to improve prothesis function for amputees, and to reduce neuroma pain in patients. The procedure can also be done at the same time as amputation in an effort to prevent a neuroma from forming.

Identification and Transfer of Nerves

During an amputation nerves are cut. Post-operatively those nerve ends may for disorganized clusters called neuromas. These can be extremely painful and may lead to difficulty wearing a prosthesis.

Targeted muscle reinnervation is one option to address these neuromas. With this technique the neuroma is identified and removed. Utilizing a nerve stimulator a redundant motor nerve in a nearby muscle is identified. The nerve that had the neuroma is then transferred to the redundant motor nerve to allow the nerve to heal and hopefully prevent recurrent neuroma formation. Since a redundant motor nerve was used, there should be negligible affect on the muscle function in that extremity.

Recovering from TMR

Recovery varies with each patient and we will follow you closely. If you are an amputee, once your incisions are well healed you will be permitted to wear your prosthesis. TMR patients with no history of amputation may be placed in a splint depending on the location of the neuroma and surgery. While there is no guarantee of pain relief with the procedure, the majority of patients note an improvement in symptoms immediately after the procedure.