Denervation is the cutting of nerves or nerve tracts so that they do not transmit information to the brain and, conversely, the brain can no longer send information via the denervated nerve. In the majority of cases, the procedure is performed to eliminate unwanted, mostly chronic pain. Denervation can also be a therapeutic option for spastic paralysis and various neurological diseases.
Forms and benefits
There are various “points of attack” at which nerves or nerve tracts can be severed. Rhizotomy: In rhizotomy, one of the posterior spinal roots is cut through, or its transmission is interrupted with the help of medication. The spinal nerve is better known as the nerve that is made up of spinal cord fibres and that emerges from the spinal column and supplies the body with nerves at different points depending on the height at which it emerges from the spinal column.
This nerve, however, consists of an anterior and posterior part before its junction. The front part contains nerve fibres which are passed on to muscles via the spinal nerves and their branches and are responsible for the contraction of the muscle. Sensitive information, which includes the sense of touch and above all the sensation of pain, is transmitted to the brain via the rear part of the spinal nerve in order to be processed there.
If this posterior part of the spinal nerve is severed, pain or even spastic paralysis can be improved. Renal denervation: Renal denervation is the destruction of overactive renal nerves. This is usually done by sclerotherapy.
The reason for this step is a persistently high blood pressure, which could not be adjusted to normal values with diet and exercise, nor with medication. The kidneys are mainly responsible for our water and salt balance and thus also for our blood pressure. Chordotomy: The chordotomy is one of the last measures to be taken in the therapy of chronic chronic pain which is extremely stressful for the patient.
Especially people with malignant tumor diseases and associated severe tumor pain in the area of the chest, abdomen or in the area of the arms and legs can benefit greatly from this minor surgical intervention. The anterior strand of the spinal cord is severed, which is known to transmit pain information from the body to a control centre in the brain. The rest of the spinal cord is spared during this operation. Ramikotomy: The Ramikotomy is particularly beneficial for patients who sweat excessively. The corresponding nerves are severed and the sweating is reduced.
Implementation
Whereas in the past, operations were performed with the help of a scalpel, today more gentle methods are used. The nerves are usually sclerosed in a small endoscopic operation, i.e. under camera view. Sclerotherapy has the advantage that work can be carried out with millimetre precision in the smallest of spaces and the surrounding tissue and other surrounding nerves are spared. In some cases, a blockage of the nerve transmission by the introduction of medication is also a possibility. Botox is very often used for this.
