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failed morton’s neuroma surgery

Schwannoma Removed During Complex Peripheral Nerve Surgery

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Complex Peripheral Nerve Surgery Solves Chronic Pain Problem

Marilyn came to see Dr. Tollestrup for a complicated peripheral nerve pain problem. Dr. Tollestrup performed a tedious peripheral nerve surgery which fixed her issue permanently. This is her story,

For many years, Marilyn’s ankle was swollen. When she bumped her ankle, she would feel a painful electric shock sensation radiating down into her foot. A CT scan showed a tumor involving the right posterior tibial nerve.

The preliminary diagnosis was a schwannoma, a tumor found in peripheral nerves. Schwannomas are usually benign. But because they are located in peripheral nerves, schwannomas can cause significant nerve pain and weakness.

When a schwannoma grows inside a nerve, the rest of the nerve fibers end up plastered to the outside of the tumor kind of like spaghetti stuck to the outside of a balloon. This can make surgery to remove the tumor difficult.

With this diagnosis in mind, Dr. Tollestrup brought Marilyn to the operating room.

First, he decompressed nerves in the medial ankle area. Using an overhead operating microscope, he then carefully dissected the tumor out of Marilyn’s tibial nerve without injuring any of the other important nerve fibers.

The surgery was a complete success! Marilyn no longer has to endure the sharp, shooting pains in her ankle. Additionally, Dr. Tollestrup was also able to preserve normal sensation to the bottom of Marylin’s right foot.

Here is what Marilyn had to say about her experience. Take a listen here.

If you or someone you know has a peripheral nerve injury or pain of an undiagnosed peripheral nerve origin, Dr. Tollestrup may be able to help. Please fill out a form on the right or call the office at 702-666-0463.

Denervation Surgery Heals Patient Suffering from a Failed Morton’s Neuroma Excision

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Denervation Surgery Heals Patient After a Failed Morton’s Neuroma Excision

Ronald is a 72-year-old gentleman who underwent an excision of a Morton’s neuroma through an incision on the top of his foot. The doctor who did the original surgery cut out the “neuroma” of the nerve on the bottom of the foot that goes to the second webspace. The procedure was complicated by a postoperative wound infection with MRSA which took months to heal.

Ronald went on to develop chronic severe pain in the ball of the left foot. He subsequently had a second attempt at re-excision of the true neuroma via an approach through the ball of the foot. Unfortunately, this did not improve his pain. In fact, the pain became wore worse and spread rapidly, eventually involving most of the ball of the foot and the first three toes.

At this point, Ronald came to see Dr. Tim Tollestrup who formulated a surgical plan to excise the neuroma once and for all.

Dr. Tollestrup operated on him via an approach through the non weight bearing arch of the foot. Once he cut into the foot, he found the damaged nerves, disconnected them and then sewed on nerve grafts to the end of the native nerves to prevent painful neuromas from forming again.

Five months post op, Ronald came to see Dr. Tollestrup. His quote to Dr. Tollestrup was that his foot is “1000% better.” He is able to walk again without the severe constant pain that he had before surgery.

For patient’s who have failed Morton’s neuroma surgery, there is now a very good surgical option to treat the pain. This novel approach involves making an incision in the non weight bearing arch of the foot. The surgeon then identifies the injured nerves and disconnects them far enough back that they are no longer located in the weight bearing area of the foot. Nerve allografts are then sewn onto the ends of the native nerves which prevents the formation of another painful neuroma resulting in the elimination of the debilitating chronic pain associated with this problem.

For patients who have failed Morton’s neuroma surgery, this surgical option can literally change their lives, just like it did Ronald’s!

Morton's Neuroma Patient

Denervation surgery helped Ronald get back on his foot after failed Morton’s Neuroma surgery.*

*Disclaimer

We do not guarantee any specific results or outcomes for surgery, should our practice work on your behalf. Information on this website may be used as a reference for successes we’ve achieved for our patients, and not as an assurance or guarantee for similar results in all instances.

Failed Morton’s Neuroma Surgery Patient Gets Relief with Nerve Decompression Surgery

By | Dr. Tollestrup Blog, failed morton's neuroma surgery, Patient Stories | 2 Comments

Failed Morton’s Neuroma Surgery Patient Story

Failed Morton’s Neuroma is a common problem that brings many patients to Dr. Tollestrup. Gail is one such patient. She shared her story in hopes of reaching others like her.

Here are Dr. Tollestrup’s patient notes on Gail. We are so happy to see she is doing well!

After a failed Morton's Neuroma Surgery Gail found relief after nerve decompression surgery with Dr. Tollestrup.

After a failed Morton’s Neuroma Surgery Gail found relief after nerve decompression surgery with Dr. Tollestrup.*

“Gail is a 73-year-old woman who presents for evaluation of pain in the ball of the right foot. She underwent an excision of a “Morton’s neuroma”, in 2013. Although this surgery gave her some relief, she continued to have pain in this area making it difficult to walk for extended periods.

Approximate six months ago, the pain in the area of the Morton’s neuroma excision started to become much more severe with radiation of pain into the second and third toes. She describes the pain as “burning and electrical shocks.” The pain is now significantly impacting her ability to walk and enjoy some of her favorite pastimes such as golf.

A “Morton’s Neuroma” is a common diagnosis. This is not a true neuroma but orthopedic surgeons, podiatrists, etc. are not aware of that. It is in fact just a compression of the common plantar digital nerve between the metatarsal heads where the nerve must pass underneath the transmetatarsal ligament. This compression point often produces some swelling in the nerve which is then misinterpreted on ultrasound or MRI as a true neuroma.

The correct treatment for this type of nerve compression should be to surgically decompress the nerve by dividing the transmetatarsal ligament and any other tissue which is compressing the nerve. Traditional teaching, unfortunately, has been to cut out the swollen nerve (thinking it is a neuroma) and letting the proximal end of the nerve retract back up into the foot. Sometimes this works and sometimes it doesn’t.

For patient’s who fail this approach, there are not many good options. They will often undergo attempts to kill the nerve with alcohol injections and may undergo multiple additional surgical procedures, each time cutting the nerve back a little bit. The painful neuroma will invariably reform, however, and the patient will often experience worse symptoms over time. These patients can become absolutely debilitated over time.

The best approach for these patients is one I developed whereby the incision is placed in the arch of the foot and the correct nerve or nerves which are damaged are identified and disconnected. Then a cadaveric nerve allograft is micro surgically sewn on to the end of the native nerve. This allows the native nerve end to grow into the graft which is long enough that it can’t reach the other end. The native nerve ends up “burning itself out,” so to speak, which prevents it from forming a new painful neuroma.

In Gail’s case, she loved taking longs walks and was to the point where she could barely walk at all without horrible pain in the right foot.

She is now about 10 weeks out from her surgery and is back taking long walks without any pain in the bottom of her foot.

If you or someone you know is suffering from chronic pain Dr. Tollestrup can help. Call our office at 702-666-0463

*Disclaimer

We do not guarantee any specific results or outcomes for surgery, should our practice work on your behalf. Information on this website may be used as a reference for successes we’ve achieved for our patients, and not as an assurance or guarantee for similar results in all instances.