Surgical decompression of nerves in leprosy. An attempt at prevention of deformities. A clinical, electrophysiologic, histopathologic and surgical study

Abstract

Forty-five leprosy patients were electively subjected to extraneural decompression and medial longitudinal epineurotomy in anticipation that relief from compression may favorably alter the course of the disease by retrieving reversibly damaged nerve bundles and preventing further progression of disease. Neurolysis was performed in 69 nerves, including the ulnar, median, lateral popliteal and posterior tibial. The period of follow-up was up to three years. Excellent sensory recovery was seen in most patients while motor recovery was less predictable. The recovery seen was better in those patients taking treatment early and also at the age the surgery was carried out. Motor damage appeared more severe in the 10-20 year age group. Most of the beneficial effects can be explained on the basis of increased vascularity due to relief from extraneural and intraneural compression.