neurectomy

Neurectomy is a surgical procedure in which a peripheral nerve or a portion of it is removed or transected to interrupt nerve conduction. It is performed to relieve stubborn focal pain, treat nerve entrapments, or address certain autonomic or glandular conditions by interrupting abnormal nerve signals.

Common indications include morton's neuroma, where a segment of the digital nerve is removed to relieve forefoot pain, and various focal neuropathic pain syndromes. It may also be used as part of treatment for severe facial or limb neuralgias when other therapies have failed, though outcomes vary by condition.

Techniques range from complete nerve resection to selective or partial neurectomy. In selective techniques, specific fibers are targeted or intrafascicular dissection is performed to balance pain relief with preservation of function. Procedures may be done openly or with microscope magnification and under general or regional anesthesia.

Outcomes are variable. Neurectomy can provide meaningful pain relief for many patients, but numbness and altered sensation in the nerve distribution are common. Possible complications include neuroma formation, persistent pain, infection, and, rarely, anesthesia dolorosa or motor deficit depending on the nerve involved.

Neurectomy is distinct from rhizotomy (spinal nerve root disruption) and from neurolysis or nerve grafting. The decision to perform a neurectomy requires assessment of potential functional loss against expected analgesia and patient goals, with consideration of alternative therapies such as blocks, medications, or neuromodulation.