Treatment at the Peripheral Nerve Center
At NYU Langone’s Peripheral Nerve Center, our surgeons have access to advanced technology and use the most current surgical techniques. Our goal is to help you overcome injury and illness and improve your quality of life.
Peripheral Nerve Conditions We Treat
We provide treatment for many nerve conditions, including greater occipital nerve entrapment, hereditary predisposition to pressure palsies, neurogenic thoracic outlet syndrome, pronator syndrome, radial tunnel syndrome, superficial sensory radial nerve entrapment, supinator syndrome, suprascapular nerve entrapment, and ulnar nerve compression at the elbow or the wrist.
We also have one of the few advanced programs for the minimally invasive surgical treatment of hyperhidrosis, which is a condition that causes excessive sweating in the palms and soles of the feet that can interfere with patients’ quality of life. Dr. Noel Perin heads the program and specializes in endoscopic minimally invasive surgery. For certain patients, the surgery can greatly improve quality of life.
Specialists at the Peripheral Nerve Center also treat people who have carpal tunnel syndrome, double crush syndrome, meralgia paresthetica, Morton's neuroma, neurogenic pyriformis syndrome, peroneal nerve entrapment at the fibular head, and pudendal nerve entrapment.
In addition, our doctors care for people with nerve injuries, including brachial plexus injuries, inguinal neuralgia, obturator nerve injury and entrapment, painful neuromas, peroneal nerve injury and foot drop, radial nerve injury, scapular winging, and spinal accessory nerve injury.
We also offer treatment for peripheral nerve tumors, including lipomas involving nerves, malignant nerve sheath tumors and malignant peripheral nerve sheath tumors, metastatic and infiltrative tumors involving nerves, neurofibromatosis, plexiform neurofibromas, radiation plexitis, schwannoma, schwannomatosis, solitary neurofibromas, and synovial cyst.
Peripheral Nerve Procedures
When nerves have been cut or torn, our surgeons perform nerve repair surgery to reattach the nerve ends. If the damaged nerves are not long enough to stitch together, we perform a nerve graft from the leg or a nerve transplant using a donor. If a nerve graft is not feasible, we perform conduit nerve repair in which small, absorbable tubes, called conduits, are used to connect and protect the nerves.
When a nerve is pulled from the spinal cord, such as when a person has a brachial plexus injury that affects the shoulder and arm, we perform either nerve transfer, using a nerve from another part of the body to restore movement, or end-to-side repair, which works to repair a partially functioning nerve. We also perform contralateral C7 transfer, using the nerve root from the seventh bone in the cervical spine from the unaffected side of the body to repair the injured brachial plexus. For severe brachial plexus injuries, muscle and tendon transfers may be considered.
We also perform a procedure called neurolysis, either external or internal, to remove scar tissue that could trap nerves.
Our neurosurgeons use the latest in diagnostic and surgical technology to ensure your safety.
Intraoperative Electrophysiological Monitoring in Peripheral Nerve Surgery
When the affected nerve is exposed during surgery, very sensitive electrical testing can be performed. This testing, which is not possible through the skin before the surgery, helps guide the surgeon. This testing also helps surgeons determine whether a nerve should be replaced with a graft or if it has the potential to heal if surrounding scar tissue is removed.
Other available intraoperative electrical tests can be used to monitor nerve function during tumor removal and to determine whether spinal rootlets, which connect nerve roots to the spinal cord, are intact during brachial plexus surgery.
Peripheral Nerve Stimulation for Peripheral Nerve Disorders
For severe nerve damage that does not respond to more conservative treatment, direct peripheral nerve stimulation may provide pain relief. This method works much like a transcutaneous electrical nerve stimulation unit, also known as TENS, but connects directly to the nerve, not the skin.
Peripheral nerve stimulation can ease pain associated with supraorbital neuralgia, occipital neuralgia, and inguinal neuralgia.
We also can provide tibial nerve stimulation for people who have had unsuccessful Morton's neuroma surgery. An electrode is placed on the nerve for a short trial period. If it helps, a small programmable pacemaker is placed under the skin. The unit can then deliver pain relief as needed and be switched off when the pain subsides.