Denervation

definition

Denervation is a severing of nerves or nerve tracts so that they do not transmit any information to the brain and, conversely, the brain can no longer send information via the denervated nerve. In the majority of cases, the procedure is carried out to eliminate undesirable, mostly chronic pain. Denervation can also be a therapeutic option for spastic paralysis and various neurological diseases.

Forms and uses

There are various "points of attack" at which nerves or nerve tracts can be severed.

Rhizotomy: At the rhizotomy one becomes the posterior spinal roots severed, or their Forwarding with the help of Medication interrupted. The spinal nerve is better known as the nerve, which is made up of spinal cord fibers and from the Spine steps outwards and the body, depending on the height of the outlet Spine in different places with Nerves supplied. However, this nerve consists of one before it joins front and rear portion. In the front part there are Nerve fiberspassing through the spinal nerve and its branches too Muscles be forwarded and there for the Contraction of the muscle are responsible. Be over the back of the spinal nerve sensitive information, to which among others the sense of touch but above all, too the sensation of pain count, forwarded to the brain to be processed there. If you cut through this rear part, that's through it an improvement in pain or also from spastic reasons Paralysis possible.

Renal denervation: Under renal denervation one understands the destruction of overactive renal nerves. This is usually done by means of Desolation. The reason for this step is a persistent high blood pressurewho neither with nutrition and Sports, could still be adjusted to normal values ​​by medication. The Kidneys are largely responsible for our water and salt balance and thus also for our blood pressure.

Chordotomy: The chordotomy is one of the last measures to be taken in the treatment of chronic, for the sufferer of extremely stressful chronic pain. Especially people with malignant tumor disease and associated severe Tumor pain in the area of Rib cage, Belly or in the area of poor and legs can benefit greatly from this minor surgical procedure. There becomes the front one Cord of the spinal cord severed, of which we know that the body's pain information is sent to a control center in the brain to get redirected. The rest of the spinal cord remains with this operation spared.

Ramicotomy: The ramicotomy comes first Patient to good that sweating excessively. Appropriate annoy are doing this severed and the sweat so contained.

execution

While the interventions earlier with help of a Scalpels have been carried out today gentler methods for use. The nerves are usually under a small one endoscopic surgery, so under Camera view desolate. The desolation has the advantagethat in the smallest of spaces accurate to the millimeter can be worked and the surrounding tissue and other surrounding Spared nerves become. In some cases, blocking nerve conduction through the introduction of medication is also an option. This is done very often Botox used.

After Wilhelm

The denervation after Wilhelm describes a Surgical techniquethat is supposed to help people with tennis elbow help relieve their pain. At the Tennis elbow the pain is mainly due to the Tendon attachment points of the elbow bone. By Interruption in the transmission of stimuli between two pain-conducting nerves in this area, can the complaints contained become. Both nerves are Departures of the radial nerve. At more correct Execution arise after the operation no loss of muscle strength or of motor skills, in other words, the ability to move and perform.

knee

The severing the sensitive, pain reliever Nerve fibers of the knee is the last step to treat chronic, non-relieving knee pain. reason joint wear, i.e. the Osteoarthritis of the knee. Usually will first tries the "broken" knee through one Knee prosthesis to replace. If the pain then persists or even worsens, denervation can be an effective means of relieving pain. The responsible nerve cords run away outside the joint. This means that no further intervention in the form of a joint reflection or the like on the knee joint is necessary. The skin on the knee joint becomes as part of a small, gentle operation with the help of a small skin incision opened, the responsible annoy detected and the forwarding interrupted. The nerves, the supply the muscles, become left and not destroyedso that the mobility of the knee joint and the strength of the Leg after the procedure not affected is. Many affected report through the following Freedom from pain even over better mobility.

Sacroiliac joint

The sacroiliac joints (ISG) connect the spine with the pool. Some medical conditions, among others ankylosing spondylitis go with inflammatory and degenerative changes in the area of ​​this Joints hand in hand what to severe pain, especially when moving can lead. First should be tried by means of the pain physiotherapy and the gift of pain reliever medication to meet. If this therapy does not bring any improvement in the long term, denervation of the pain-conducting ileo-sacral joint nerves can lead to an improvement in the pain situation. These fibers are in the context of a small operation, technically as Radio frequency neurotomy marked, desolate and thus switched off.

facet

The facet joints serve the articulated connection between two Vertebral bodies. Each vertebral body possesses on the left and right side respectively two top and two lower facet articular surfaces, the upper articular surface of one vertebral body forming the articulated connection with the lower one of the vertebral body above it. Even these little ones Joints can through their frequent and intensive use of inflammatory events and degenerative changes, speak one Facet joint arthrosis to be affected. This leads to severe painoften associated with Move and at Extension of the spine occur. To Beginning can physical therapy, pain reliever drugs and the injection of local narcotics and Cortisone remedy create against the pain. Will this however chronic and can do it yourself Medication not in their intensity be reduced, can a facet denervation, so a severing of the pain-conducting fibers on the small joints the way to Freedom from pain be. In the majority of cases, this small procedure can even be carried out on an outpatient basis. The pain nerve boxes are connected to one by the skin pierced needle is detected and obliterated with current given over it.

patella

The most frequent reason For chronic kneecap pain (technical language: patella), is again the degenerative wear as a result of Overloads. Especially athletewho exercise at their sport much leap must (long jump, high jump, volleyball, basketball) suffer from it. In the long term, the pain can become so bad that you have to take a longer break or give up sport, which, in addition to the pain, represents a great loss of quality of life for those affected. Preventive overuse before exercise a good muscle stretch and a warm-up program be performed. By denervating the pain-conducting fibers in the area of ​​the kneecap, the quality of life can be maintained by eliminating the pain and sport can be resumed after a short recovery phase.