Targeted muscle reinnervation, or TMR, was originally developed at Northwestern Plastic Surgery to help individuals who have lost limbs to cancer, traumatic injuries, or other medical reasons regain better control and tolerance of prosthetics. Historically, the procedure was performed months or years after amputation surgery.
However, Dr. Jason Ko and his colleagues at Northwestern Medicine and in the U.S. military discovered another benefit of surgery: it improves and sometimes prevents pain related to amputation. This is significant, as an estimated 75 percent of individuals with limb loss experience debilitating residual limb or phantom limb pain after amputation. Dr. Ko was the Co-Principal Investigator of the clinical trial funded by the U.S. Department of Defense that proved that TMR significantly decreased neuroma pain and phantom limb pain in upper and lower extremity amputees. Dr. Ko and his colleagues later demonstrated that TMR performed at the time of the initial amputation prevents neuroma pain and phantom limb pain from ever developing and is more effective than TMR performed months or years after the amputation.
Targeted muscle reinnervation is available in Chicago with Dr. Ko. If you have had a previous amputation, or you are facing future amputation due to an illness, Dr. Ko encourages you to talk to him about your treatment options.
Understanding Nerve Pain and Targeted Muscle Reinnervation
The easiest way to understand why pain develops after amputation of a limb is to imagine cutting through a live wire. After the wire is severed, electrical shocks continue to course through the ends. Like the cut wire, the ends of the nerves that used to be connected to the amputated limb have nowhere to go once the limb is removed. These tangles of disorganized nerve endings that form after amputation are called “neuromas.” They continue to send signals to the brain that can be interpreted as pain.
Another problem commonly faced by those who have lost limbs is phantom limb pain, or stabbing, shooting or burning pain that seems to come from the limb that is no longer there. Sometimes this pain is so great that it interferes with activities of daily living.
Targeted muscle reinnervation has been shown to help reduce neuroma and phantom limb pain by rerouting the nerves transected during amputation into motor nerves in nearby muscles. This gives the previously disconnected signals “somewhere to go and something to do,” and tricks the brain into thinking the amputated limb is still there.
What Targeted Muscle Reinnervation Can Do for You
If you have unrelenting pain from a previous amputation, targeted muscle reinnervation can be performed to reduce the pain and improve your quality of life. Or, if you are facing amputation of a limb, TMR can be performed at the time of the surgery to prevent the formation of neuromas and the onset of phantom limb pain.
After TMR, you will be fitted with a special prosthetic and undergo an in-depth rehabilitation process to learn how to control it. If, for example, you had your arm amputated above your elbow, TMR can help you move your arm prosthetic in complex and refined ways merely by thinking about the action you wish to perform. With TMR, it becomes possible to grip objects in your prosthetic hand, rotate your wrists, and flex your elbows. Without the constant pain caused by severed nerves, you will have the opportunity to better tolerate and control your prosthetic. Dr. Ko works with amputation and prosthetic specialists at the Shirley Ryan Ability Lab, the #1 rehabilitation hospital in the country, to provide comprehensive care to all amputees that undergo TMR surgery.
Learn More About Targeted Muscle Reinnervation
Dr. Ko routinely performs TMR and has extensive experience with this complex surgery. He would be happy to discuss how TMR can significantly improve your quality of life during an in-person consultation. For more information about this revolutionary procedure, please contact the practice of Dr. Ko and request an appointment.