An Analysis of Pain and Quality of Life in Patients Undergoing Targeted Muscle Reinnervation After Upper-Limb Amputations

Abstract

ABSTRACT Introduction Targeted muscle reinnervation (TMR) surgery is now increasingly performed when individuals with amputation develop problems with chronic, nerve-related limb pain. This study evaluates the effectiveness of TMR for individuals with upper-limb amputations in terms of quality-adjusted life years (QALYs) and subjective neuroma pain (NP) and phantom limb pain (PLP). Methods A retrospective single-center study assessed patient-reported outcome measures in postoperative TMR patients. Digital records were analyzed, and telephone interviews were conducted for all patients over an 8-year period. Results Significant reductions were observed in NP (−3.9, P < 0.01) and PLP (−4.9, P < 0.01), as well as an improvement in VAS scores (pre-TMR mean = 60.7, post-TMR mean = 76.3, P < 0.01) and pain scores (pre-TMR mean = 3.6, post-TMR mean = 2.5, P < 0.01) on the Euroqol EQ5D-5L scale. Conclusions We observed significant improvements in NP and PLP after TMR surgery, as well as improved pain scores on the EuroQol EQ5D-5L scale. This suggests that TMR may represent a reasonable management option for patients with nerve-related pain after an upper-limb amputation. More work needs to be done in the form of randomized controlled studies and economic analyses to quantify benefit and scalability. Clinical Relevance This article adds to the body of evidence in support of the potential important role of TMR in the management of chronic pain after upper-limb amputations.