Division of Vascular Surgery, Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Division of Plastic and Reconstructive Surgery, Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Vascular. 2024 Feb;32(1):154-161. doi: 10.1177/17085381221124982. Epub 2022 Sep 4.
The purpose of this narrative review is to provide the vascular surgery community with updated recommendations and information regarding the use of Targeted Muscle Reinnervation (TMR) for both the prevention and treatment of chronic pain and phantom limb pain occurring in patients after undergoing lower extremity amputation for peripheral artery disease.
Current available literature discussing TMR is reviewed and included in the article in order to provide a succinct overview on the indications, clinical applications, and surgical technique for TMR. Additionally, early studies showing favorable long-term results after TMR are discussed. Patient consent for publication was obtained for this investigation.
TMR has been demonstrated to be an effective means of both treating and preventing neuroma-related symptoms including chronic pain and phantom limb pain. It has been proven to be technically feasible, and can help patients to have improved utilization of prostheses for ambulation, which can conceivably lead to a reduction in mortality.
TMR is an important tool to consider for any patient undergoing lower extremity amputation for a vascular-related indication. A vascular-plastic surgeon dual team approach is an effective means to prevent and reduce neuromas and associated chronic pain in this patient population.
本叙述性综述的目的是为血管外科学提供有关靶向肌肉神经再支配（TMR）的最新建议和信息，用于预防和治疗因外周动脉疾病行下肢截肢后发生的慢性疼痛和幻肢痛。
回顾了目前有关 TMR 的可用文献，并将其纳入文章中，以便简洁地概述 TMR 的适应证、临床应用和手术技术。此外，还讨论了早期研究表明 TMR 后的长期结果良好。患者同意发表此研究。
TMR 已被证明是治疗和预防神经瘤相关症状（包括慢性疼痛和幻肢痛）的有效手段。它已被证明在技术上是可行的，并可以帮助患者更好地使用假肢进行行走，这可以想象地降低死亡率。
对于任何因血管相关原因行下肢截肢的患者，TMR 都是一个需要考虑的重要工具。血管-整形外科医生的双重团队方法是预防和减少该患者群体中神经瘤和相关慢性疼痛的有效手段。
