PERSISTENCE OF SYMPTOMS AFTER SURGICAL RELEASE OF COMPRESSIVE NEUROPATHIES AND SUBSEQUENT MANAGEMENT

Persistent symptoms following release of a compressive neuropathy may be the result of the wrong diagnosis, inadequate decompression, iatrog enic compression, double-crush syndrome, or end-stage disease. Managem ent of the patient requires careful re-examination of all available da ta to arrive at a correct diagnosis while ruling out other elements of the differential diagnosis. Revision surgery is indicated only with a confirmed diagnosis. Revision surgery must relieve residual nerve com pression, maintain or enhance neurovascularity, prevent neuritises, an d provide protective padding of the entrapped nerve.