Nerve transfers to restore femoral nerve function following oncologic nerve resection.

Abstract

INTRODUCTION:

Advances in the care of soft-tissue tumors, including imaging capabilities and adjuvant radiation therapy, have broadened the indications and opportunities to pursue surgical limb salvage. However, peripheral nerve involvement and femoral nerve resection can still result in devastating functional outcomes. Nerve transfers offer a versatile solution to restore nerve function following tumor resection.

METHODS:

Two cases were identified by retrospective review. Patient and disease characteristics were gathered. Preoperative and postoperative motor function were assessed using the Medical Research Council Muscle Scale. Patient-reported pain levels were assessed using the numeric rating scale.

RESULTS:

Nerve transfers from the obturator and sciatic nerve were employed to restore knee extension. Follow up for Case 1 was 24 months, 8 months for Case 2. In both patients, knee extension and stabilization of gait without bracing was restored. Patient also demonstrated 0/10 pain (an average improvement of 5 points) with decreased neuromodulator and pain medication use.

CONCLUSION:

Nerve transfers can restore function and provide pain control benefits and ideally are performed at the time of tumor extirpation. This collaboration between oncologic and nerve surgeons will ultimately result in improved functional recovery and patient outcomes.

• Authors: Andrew L O'Brien, Julie M West, Abbie Zewdu, Valerie P Grignol, Thomas J Scharschmidt, Amy M Moore
• Journal: Journal of surgical oncology (J Surg Oncol) Vol. 124 Issue 1 Pg. 33-40 (Jul 2021) ISSN: 1096-9098 [Electronic] United States
• PMID: 33831232 (Publication Type: Case Reports, Journal Article)
• Copyright: © 2021 Wiley Periodicals LLC.

Topics

• Adult
• Aged
• Female
• Femoral Nerve (injuries)
• Humans
• Liposarcoma (pathology, surgery)
• Male
• Nerve Transfer (methods)
• Neurilemmoma (pathology, surgery)
• Peripheral Nerve Injuries (etiology, pathology, surgery)
• Retrospective Studies
• Soft Tissue Neoplasms (pathology, surgery)