Complex salvage procedures for severe lower extremity nerve pain

From 1995 to 1999, the senior author did revision nerve release and vein wr apping (58 limbs in 58 patients) or peripheral nerve stimulation (62 limbs in 62 patients) to relieve intractable lower extremity nerve pain. Vein wra pping was done if the patient had temporary relief after a previous nerve r elease, if there was evidence of scarring around the nerve, and if nerve pa in was triggered by mechanical stimulation. Peripheral nerve stimulation wa s done when previous nerve operations provided no relief or if the nerve pa in was more constant and spontaneous without mechanical provocation. The du ration of symptoms preoperatively averaged 52 months, and the number of pre vious peripheral neurosurgical interventions averaged 2.5. Postoperatively, the average pain improvement was rated as 60% for the patients who had vei n wrapping and 41% for the patients who had peripheral nerve stimulation. O f the patients who had vein wrapping, 53% were satisfied, 14% were somewhat satisfied, and 33% were dissatisfied. Of the patients who had peripheral n erve stimulation, 61% were satisfied, 21% were somewhat satisfied, and 18% were dissatisfied. Most patients (78%) stated they would undergo the proced ures again.