Peripheral Nerve Surgery | Department of Neurosurgery

What is peripheral neuropathy?

Peripheral nerves are located outside of the brain and spinal cord. Peripheral nerve damage, or peripheral neuropathy, occurs when these outer nerves are damaged, leading to numbness, tingling, weakness, and pain. In some cases, peripheral neuropathy can also disrupt other bodily functions, such as the bladder or bowels.

There are many different types of peripheral neuropathy. Some patients require less invasive treatment options, while some require surgery to alleviate pain and restore function. Dr. Attiah performs surgical procedures for patients with nerve injury, nerve tumors, and entrapment or compression syndromes like carpal tunnel.

Peripheral Nerve Surgery at UNC Health

Brachial Plexus and nerve injury illustration — Illustration: Xian Boles, MFA

Dr. Mark Attiah is the Director of Peripheral Nerve Surgery for the Department of Neurosurgery at UNC Health. He is one of only a few neurosurgeons in the country who specializes in the treatment of complex peripheral nerve disorders leading to extremity pain and weakness.

Dr. Attiah uses techniques including intraoperative electrical stimulation and endoscopy to treat patients with peripheral nerve disorders. His extensive training in spine surgery allows him to help patients with spinal cord injuries restore function from the spinal cord to the nerves that go to the muscles of the arms and legs.

A severe brachial plexus injury can occur after a traumatic injury to the neck. This type of injury can cause severe pain, numbness, lack of mobility, function, and feeling in the arm or hand. Physical therapy and other nonsurgical methods can be used to treat minor brachial plexus injuries, but severe brachial plexus injuries, such as an avulsion, may require surgery.

An avulsion occurs when the nerve root is disconnected from the spinal cord, causing partial or full paralysis. Brachial plexus surgery is typically followed by outpatient physical therapy.

Dr. Attiah treats patients with:

Compressive peripheral nerve disorders

Carpal Tunnel (median nerve at the wrist)
Cubital Tunnel (ulnar nerve at the elbow)
Fibular tunnel (peroneal nerve at the knee)
Neurogenic thoracic outlet syndrome
Meralgia paresthetica (lateral femoral cutaneous nerve)
Radial tunnel syndrome
Guyon’s canal (Ulnar neuropathy at the wrist)
Tarsal tunnel (tibial neuropathy at the ankle)
Thoracic outlet syndrome

Nerve Injuries

Shoulder weakness from shoulder dislocation or surgery (axillary nerve)
Shoulder weakness from spine surgery (C5 palsy)
Foot drop from Knee dislocation or surgery (peroneal nerve)
Wrist drop from humerus fracture (radial nerve)
Sciatic nerve injury from hip surgery

Nerve Pain

Traumatic neuroma treatments
Amputation neuromas
Brachial plexus avulsion injury pain

Nerve Tumors

Malignant peripheral nerve sheathe tumors
Perineuriomas
Peripheral nerve tumors
Neurofibromatosis type I
Neurofibromatosis type II
Schwannomatosis

Diagnostics

Muscle biopsy
Nerve biopsy
Peripheral nerve ultrasound
Electromyography/nerve conduction studies
Diagnostic and therapeutic nerve blocks

Carpal tunnel and cubital tunnel illustration — Illustration: Xian Boles, MFA

Nerve transfers illustration — Illustration: Xian Boles, MFA

Tunnel fibular illustration - UNC Health. Image by Xian Boles, MFA — Illustration: Xian Boles, MFA

Peripheral Nerve Treatment at UNC Health

Thoracic outlet syndrome - UNC Health peripheral nerve surgery — Illustration by Xian Boles, MFA

The Peripheral Nerve Center at UNC Health uses a team-based approach to care for patients with peripheral nerve problems ranging from the simplest to the most complex. Our multidisciplinary team consists of providers from orthopedic surgeons, nonoperative orthopedic physicians, neurosurgeons, physiatrists, rehabilitation specialists, neurophysiologists, musculoskeletal radiologists, and hand therapists.

Read more about the Peripheral Nerve Center at UNC Health.

Neurofibromatosis Program at UNC Health

Nerve Sheath Tumors — Illustration: Xian Boles, MFA

Neurofibromatosis type 1 (NF1) is a genetic condition that causes tumor growth along the nerves. These tumors are typically benign, but often become malignant and require a multidisciplinary treatment approach that includes physicians from neuro oncology. Because of the various locations of the tumors in the body, other medical and surgical specialties may be part of a patient’s care team.

Learn more about the neurofibromatosis program at UNC Health.