This is silvester at the next step foot and ankle , and im going to talk to you a little bit today about something that, for our neuropathy patients, has been a real game changer. Its really given us another powerful tool in being able to eliminate or significantly decrease the symptoms of painful peripheral neuropathy. Theres also significant evidence that this procedure, this treatment that we do, actually helps the nerves regrow helps the nerves to heal and become better. Its a matter of circulation.
In the nerve, its also a matter of opening the gates that how a nerve functions is that there are gates that allow electrical currents to pass down the nerve, and the nerve uses a lot of energy to keep those gates either open or closed, depending on what its trying to do. The anatomy of a nerve is such that if you took a nerve out of this young ladys back and down to her foot. If you spread that nerve out and magnified it at maybe 1000 times,.
The relative proportions of the nerve would be like a string the length of a football field. A nerve uses more energy than any cell in the body, so the nerve, being that long and that skinny, the nerves ability to heal itself and deliver energy to all those little gates all along that nerve is somewhat hampered. This treatment tends to restore that and helps the nerve heal. Its a very simple procedure, and Im going to show you this is the machine, its called the Neurogenx 4000.
Pro. it has an electrical current that goes into the nerve and helps fire the nerve repeatedly over a period of time. Our treatments last about 3045 minutes, depending on the severity of the patients symptoms. We do this with an integrated nerve block. Im going to show you where the nerves come down into your leg. Theres one right here, and this is called the common peroneal nerve. Were going to put one patch there. Theres a nerve right back here, and this is the tibial nerve, and that comes down right there, and.
Well put a patch there. all the nerves that innervate the bottom of the foot come through here, and this is called the tarsal tunnel and the plantar nerves. Then on the top of the foot theres also a deep peroneal nerve and there are also branches of the superficial peroneal nerve that are up here. Depending on where the symptoms are the worst, we kind of move the pads to try and treat the nerves that were involved with. If you dont have very many symptoms on the deep peroneal nerve, we do it up here at the superficial.
Peroneal nerve. The first pad goes over the common fibular nerve, the next one goes back here where the tibial nerve comes down into the leg and its kind of deep right there. Most of the time well treat the superficial peroneal nerve. Then, on the inside of the foot, the area of the tarsal tunnel. Now thats all set up for nerve treatment, and all we do is turn the machine on, and we just bring up the intensity until the patient feels it. It shouldnt.
Be uncomfortable, but you should be able to feel it when its working. its a fairly substantial current. The next thing that we do with this is either during or after the procedure, we give local anesthetic blocks into those nerves that are most badly affected by nerve disease. We determine that with our al examination. Those injections consist of just a longacting local anesthetic and so the patient leaves, they may be numb for a while or they may not feel any numbness. What happens is, the signal therapy followed.
With the local anesthetic therapy causes the nerve to be able to reestablish itself as far as the surrounding environment with nutritional support, vasodilation and really helps the nerves heal themselves. This has been, in about 80% of our patients who undergo this therapy, they have significant relief of their peripheral neuropathy. Its not a one time thing. We have to do it 13 times, and sometimes we extend it beyond that. 13 treatments in general, but sometimes we extend it beyond that. Thats electrical nerve stimulation.
Medial Branch Block Demonstration LIVE
A medial branch block is a direct and noninvasive method of treating and diagnosing pain that originates in the facet joint in the spine. At the start of the procedure the patient lays down on their belly on the xray table. If the patient is sedated the vital signs are closely monitored. The skin in the side of injection is cleaned in the sterile fashion, and a numbing medicine is used to anesthetize the skin. The needles are placed with xray guidance down to the place where the medial.
Branch nerves live. The anesthetic medicine is then injected carefully through each needle in each one of those medial branch nerves and then anesthetize. After the procedure the needles are removed and the patient moves around typically extending their spine they can tell almost immediately if they pain feels better. If their pain feels better then we decide yes the joints are affected and thats when.
We consider a procedure called radiofrequency ablation, which is a much much longer lasting version of this procedure. After the procedure typically a patient goes to recovery area, they are monitored for about 30 minutes before being discharged home. Most patients experience some relief or instant relief with this procedure. Oftentimes the relief will last just the duration of the local anesthetic, sometimes it will last for days or even weeks.