Progression of peripheral nerve injury in leprosy: Evaluation of the effect of nerve decompression surgery in an endemic region of Brazil

Abstract

To evaluate the progression of nerve injury in leprosy patients undergoing peripheral nerve decompression surgery. Methodology: Observational study of retrospective, descriptive-analytical cohort. In the convenience sample, individuals with leprosy who underwent peripheral nerve decompression surgery at the Casa de Saúde Santa Marcelina, Porto Velho/RO, between 2000 and 2019 were evaluated nerve by nerve, before and after surgery. Results: Note that 574 individuals underwent 2549 surgeries of the ulnar, median, tibial and/or fibular nerves. Most individuals were male (51.6%), of brown race (80.3%), multibacillary (90.9%), aged between 31 and 60 years (73.2%) and originating from other municipalities in the state of Rondônia, Northern Region of Brazil (67.4%). Most individuals maintained or improved the GD (WHO Grade of Disability), the sensory or the motor nerve function in the limbs operated.

Effectiveness of neurolysis as a treatment for complications of leprosy neuritis: a systematic review

“…Individuals who underwent neurolysis showed partial regeneration of preoperative deformities 7,13,14,17 . One possible explanation for this rehabilitation is that surgical procedures reduce extrinsic compression allowing improvement in neural circulation, and are more effective in preventing the progression of nerve damage than other methods of recovery from physical disabilities 8,39 .…”

“…Neurolysis involves the decompression of the affected nervous trunks in a given region, reducing intraneural pressure and aiding in the treatment of neural, sensorimotor, and neuropathic pain, and, ultimately enhancing a patient's overall quality of life 7,8 . The assessment of the effects of neurolysis as an alternative method with which to treat complications from leprosy neuritis, in lieu of non-surgical interventions, such as drug therapy with corticosteroids, fills an important gap in the available knowledge of this technique, due to the paucity of research on this topic.…”