Researchers from Northwest Medicine® in Chicago, have announced that they are leading a four-year multi-center clinical trial to evaluate a new surgical method of addressing chronic pain associated with amputation of a major limb. The method, known as targeted muscle reinnervation (TMR), addresses the chronic pain experienced in about one quarter of all amputees. Pain, such as phantom limb pain, is typically caused by pain related to the scarred nerve ending (neuroma) in the remaining portion of an amputated limb that continues to send pain signals to the brain.
According to the press release, “Chronic pain from neuromas is a major reason that amputees cannot wear or use their prostheses comfortably and increases their disability.”
“The TMR therapy’s goal is to transfer a nerve that has been cut-off from the muscles it used to control and essentially plug it into a functioning muscle nearby. This is accomplished by removing the neuroma from the damaged nerve, and then surgically joining it with a healthy nerve that controls the existing target muscle. Joining these nerves together allows them to then grow into, or reinnervate, the target muscle and prevent the neuroma from reforming.”
The study is being funded, in part, by the Department of Defense’s (DoD) Office of Congressionally Directed Medical Research, as a result of the fact that “more than 1,000 active military personnel have had a major limb amputation due to combat-related injuries in recent conflicts.”
According to the release, “Since 2002, TMR has now been performed successfully more than 100 times worldwide and nearly all of the patients who had painful neuromas before the procedure reported no neuroma pain afterward.”
While the primary focus of the study is measuring the improvement in pain of the amputated limb after surgery, secondary measures include improvement in physical functioning, including prosthesis wear, after survery, and determining if TMR prevents neuroma recurrence.
The study began in October 2014 and is currently recruiting participants.
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