Throughout the world there are many people that go through amputations for a wide variety of medical reasons such as complications from diabetes, vehicular accidents, injuries from war, and so many other reasons. Many people develop phantom limb pain and other types of pain due to the nerves being damaged and healing. The scar tissue, neuroma, from the nerve healing can cause a lot of pain to the patient as there are “disorganized axons encased in scar” (Dumanian et al., 239). With so many people living in pain that cannot be controlled, finding a cure is very important. The talk with Dr. Greg Dumanian was a very interesting talk that showed an amazing surgical technique that help decrease the pain of those that suffer with phantom limb pain. This type of research is important for those that unfortunately have to get an amputation. In the U.S. News, there was an article by Cara Murez that describes another type of surgical method that would help amputees.
People suffer greatly after an amputation. There is a lot of mental struggles that develop and on top of that the issues of physical pain that people have difficulty stopping is a lot for amputees to go through. Dr. Dumanian was able to find a technique, called targeted muscle reinnervation (TMR), that lower the amount of phantom limb pain that people experienced after developing neuromas. He was able to cut away the neuroma exposing a healthy nerve, on both sensory and motor nerves, and implant it into “nearby muscles rendered functionless by the amputation” (Dumanian et al., 239-240). This led to nerves that would fire in the neuroma to fire to a different muscle which led to less pain. From this, it seems that the nerve needs to have a direct place to fire which is why, in the neuroma, it led to pain as it was just firing randomly in the mess of axons. The patients that Dr. Dumanian performed the surgery on showed that “TMR decreased phantom pain in major limb amputees, with an average decrease of 3.2 in the TMR arm compared with an average increase of 0.2 in the standard treatment arm at the defined 1-year end point” (Dumanian et al., 244) This decrease in pain is a lot of improvement for people whose lives are negatively affected by such complications. Any little amount of relief for pain is better than the original amount, even if it is slightly. Such improvements could allow people to live a life closer to what they had before their amputation.
It is important for there to be options for people to choose from as some methods may not work for one patient the way it worked for the other. There was another surgical approach in order to help relieve phantom limb pain that was found in U.S. News. With this technique called “agonist-antagonist myoneural interface, or AMI” it was able to help with “better control of muscles that remain after surgery” (Murez). This is important because many people have a lot of difficulty readjusting into life missing a leg or arm and having to use a prosthetic. One of the researchers, Shriya Srinivasan, involved in finding this technique said, “I think they’re finding themselves to feel a lot more mobile and functional after the surgery” (Murez). Having the ability to have better function in the muscles that were amputated may give the patient a better feeling of having control over their prosthetic, which would improve their life. This surgery also helps relieve phantom limb pain, which is similar to Dr. Dumanian’s surgery.
These two surgeries have made great advancements in helping amputees in lessening the pain that develops from the surgery. The ability for these types of surgeries to be performed should give many people relief and hope that their pain, one day, could be temporary or nonexistent. Dr. Dumanian and Shriya Srinivasan have created methods that improve the lives of amputees and have decreased pain that some people struggle in their day-to-day. This could just be the start of the improvement that people need, but that means that someday phantom limb pain and other amputation related pains could be eliminated.
References
Dumanian, Gregory A., et al. “Targeted Muscle Reinnervation Treats Neuroma and Phantom Pain in Major Limb Amputees.” Annals of Surgery, vol. 270, no. 2, 2019, pp. 238–246., https://doi.org/10.1097/sla.0000000000003088.
Murez, Cara. “For Amputees, a New Kind of Surgery May Allow Better Control, Sensation .” U.S. News, 9 Mar. 2021, https://www.usnews.com/news/health-news/articles/2021-03-09/for-amputees-a-new-kind-of-surgery-may-allow-better-control-sensation.
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