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Peripheral nerve surgery in Tijuana
Carpal tunnel, ulnar nerve entrapment, traumatic nerve injuries and nerve sheath tumours. Nerves are also operated on outside the skull and the spine.
Tingling in the hand does not always come from the neck
When someone arrives with tingling and numbness in the hand, the question to settle is where the compression sits. Carpal tunnel syndrome affects the median nerve at the wrist and wakes the patient in the early hours with tingling in the thumb, index and middle fingers, relieved by shaking the hand. Ulnar entrapment at the elbow numbs the ring and little fingers and worsens on leaning on the elbow or holding a phone.
A cervical herniation, by contrast, gives pain running from the neck down the whole arm. All three get confused, and electromyography together with a careful examination is what separates them. Operating a wrist when the problem was in the neck is a mistake a proper consultation prevents.
Release, repair or resect
Entrapment is treated by releasing the roof that compresses: the transverse carpal ligament in the carpal tunnel, the cubital arcade at the elbow. It is day surgery, under local or regional anaesthesia, and night-time tingling usually settles quickly when the indication was correct.
Traumatic nerve injuries — lacerations, gunshot wounds, brachial plexus traction — need early assessment to choose between exploration, neurolysis, direct suture or grafting. And nerve sheath tumours such as schwannoma are resected under the microscope, separated from the healthy fascicles, which are preserved.
What the procedure involves
When it is indicated
- Carpal tunnel syndrome with confirmatory electrophysiology
- Ulnar nerve entrapment at the elbow
- Traumatic peripheral nerve injury with motor deficit
- Nerve sheath tumour (schwannoma, neurofibroma)
- Brachial plexus traction injury
- Meralgia paraesthetica and other lower limb entrapments
Techniques and resources
- Microscope or surgical loupes
- Electromyography and nerve conduction
- Peripheral nerve ultrasound
- Microsurgical instruments
- Local or regional anaesthesia
- Targeted MRI where a tumour is suspected
Frequently asked questions about peripheral nerve surgery
If tingling wakes you in the early hours, affects thumb, index and middle fingers and improves on shaking the hand, it points to the carpal tunnel. If pain runs from the neck down the whole arm and worsens with certain neck movements, it points to the cervical spine. Examination and electromyography clarify it.
No. It is a day procedure, usually under local anaesthesia, and the patient goes home the same day with a functional hand and some strength restrictions for a few weeks.
Relief of pain and tingling usually occurs even in long-standing cases. Recovery of strength and muscle bulk is slower and may be incomplete when compression has lasted a long time. That is an argument for not postponing it.
Bring your imaging and settle the question
One consultation with your MRI or CT in hand is worth more than ten internet searches. Book by phone or through the form and you will be told what is there, what it means and what your options are.