further surgery on previous submuscular ulnar nerve transposition

[labrat]

Hello,
About 30 years ago I had a submuscular transposition on the ulnar nerve in the elbow area of my dominant arm.  It was successful however in the past 10 years the pain and weakness have become severe, thought to be because of scar tissue.

I understand that a further surgery on a submuscular transp. is by far more complicated than one on a subcutaneous, how involved is it and how are the outcomes (assuming that the nerve has to be freed from scar tissue)?  It is at the point where the pain is so prohibitive that any risk from surgery seems worthwhile (my surgeon is at a major, highly regarded teaching university and is considered the best in hand/upper extremity surgery).

Thank you.

[ontherecord]

Doctor S: I didn't get a chance to thank you for your response to my recent question since my thread was maxed out with comments, so I also wanted to take this time to thank for you for your extremely throrough and thoughful response to my previous  questions (MRI's, Prophylactic use of statins, ginkgo biloba, etc.). The information provided significant value, and once again, thank you for your timeliness and thoroughness.

[labrat]

Thank you.

An EMG/NCS was performed showing a complete block in the elbow area, and no cervical problems at all.  (This was a repeat test to confirm initial findings.)

Pardon the pun, but I am in good hands with my surgeon and am looking forward to a successful outcome.

Many thanks again.

[CCFNeuroMD]

I unfortunately was not able to get a hold of our specialist. From the literature I reviewed re-operation is not that uncommon. I could find no article which quoted the re-operative risk. However, most patients reported in the literature did have an improvement in pain after re-operation. The re-operative risk would depend on the surgeon, type of surgery, and your personal exam and anatomy. These are best discussed with your surgeon, who should quote you the risk of the surgery. If you have not seen a neurologist, it would be reasonable to make sure no other disorder is present, and perhaps a EMG (muscle/nerve test may be of some use). Our peripheral nerve surgeon in Dr Boulis, if you wish to travel for a second opinion. Good luck.

[labrat]

Thank you for your thoroughness.  I look forward to your information.

Have a nice weekend.

[CCF-Neuro-M.D.-CS]

Sorry for the delay in replying. This is a very particular question, and I want to speak with out peripheral nerve specialist before answering. I should give you an answer by Monday. Again, sorry for the delay.