One big chunk of patients with peripheral nerve problems are those who are suffering from peripheral neuropathy. A lot of studies have been done, patients with diabetic neuropathy or idiopathic neuropathy, and if they are determined to be surgical candidate based on their physical exam findings, then surgery is about 80% effective at relieving their symptoms. That’s been looked at in many different series by many different investigators, and it comes out to about 80%.
What you tell the patient is there’s an 80% chance of success and a 20% chance of failure. Success usually means that their pain goes away totally. Failure usually means that they’re just no different once they’re healed up from surgery. If they respond to that first surgery and have a good outcome, then any other surgery after that is close to a 100% success, you’ve proven the theory.
If you’re dealing with other types of peripheral nerve problems and physical exam findings are appropriate and/or diagnostic blocks relieve pain temporarily, so you’re taking local anesthetic, numbing medicine, shutting the nerve down chemically for a period of hours and that gives them relief, then surgery for those kind of problems is probably 95% successful. A lot of times, if there’s still pain leftover, it means that there’s just another nerve involved and you have to go figure that out.
