Here are seven insights:
1. The study is the first-ever published randomized clinical trial for treating postamputation pain in limb amputees.
2. Chicago-based Northwestern Feinberg School of Medicine Chief of Plastic Surgery Gregory Dumanian, MD, is the study’s lead researcher and author, as well as originator of the TMR procedure, which he said helps reduce patient pain and narcotics use while allowing more freedom to engage in physical activity.
3. Dr. Dumanian said the TMR procedure is designed to dissect the amputated nerve that causes the patient’s pain. After dissection, the nerve is surgically re-routed to a nearby functionless muscle to ‘close the circuit.’ By connecting the nerve to end receptors within the muscle, it allows it to feel ‘healed’ and less painful.
4. The study featured 28 amputees with chronic pain, who were then assigned to either standard treatment or TMR. Patients did not know whether they had received TMR or standard treatment for a year following surgery.
5. During the study, researchers at Northwestern University’s Feinberg School of Medicine gathered information on the participants, including patient-rated pain scores and neuroma size and functionality data at six, 12 and 18 months after surgery.
6. Results of patient-rated pain scores who underwent TMR were as follows:
• 72 percent felt mild or no phantom limb pain 18 months after surgery
• 67 percent felt free of or only mild residual limb pain after surgery
7. Results of patient-rated pain scores who underwent standard neuroma excision and muscle burying for chronic postamputation pain:
• 40 percent felt mild or no phantom limb pain 18 months after surgery
• 27 percent felt free of or only mild residual limb pain after surgery
Dr. Dumanian first published his TMR surgery findings in Clinical Orthopaedics and Related Research in 2014. His latest publication is the first to demonstrate significant improvements in a randomized study.
Researchers concluded, in addition to reducing amputee pain, the surgery can benefit individuals regardless of when the amputee occurred and if the patient has had prior nerve surgeries.
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