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Old 02-15-2010, 10:32 PM #1
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Default decompressions for neuropathy questions

My b.i.l. is going to the V.A. hosp to have decompression for arms and legs for neuropathy I have been trying to find info about decompression for neuropathy all I am getting is a few neuros who are doing trials for it.
I thought decompression was fairly common? as I have heard of M.V.D. for T.N. and also for O.N. they have decompression. I was wondering if anyone would have any info to share or is it that new of an idea for neuropathy to have decompression???
Thanks for any help or replies. He goes tomorrow for his arms and then his legs after he heals up from this one.
thanks again for any help.
Low pain to the room and readers.
PEACE
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Old 02-15-2010, 11:03 PM #2
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Can you explain what you mean by decompression? I am a bit slow these days...

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Burntmarshmallow (02-16-2010)
Old 02-16-2010, 04:51 AM #3
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Are you describing tarsal tunnel release, and carpal tunnel?

These are surgeries. Some people develop a chronic pain condition called RSD when the wrist or ankle is involved in a surgical procedure. I have lost count of how many come to our RSD forum with foot or ankle surgery and develop RSD.

If your BIL is really going thru with this, read this study:

Quote:
Lancet. 1999 Dec 11;354(9195):2025-8.
Effect of vitamin C on frequency of reflex sympathetic dystrophy in wrist fractures: a randomised trial.

Zollinger PE, Tuinebreijer WE, Kreis RW, Breederveld RS.

Department of Orthopaedics, Leyenburg Hospital, The Hague, The Netherlands.

Comment in:

* J Bone Joint Surg Am. 2007 Nov;89(11):2550-1; author reply 2551-2.

BACKGROUND: The pathogenesis of reflex sympathetic dystrophy (RSD) is not clear, nor is there a definitive treatment for this syndrome. The morbidity, costs in health care, and loss of work time justify the search for a means to prevent post-traumatic dystrophy. Although the role of toxic oxygen radicals has not yet been clarified, we investigated vitamin C (ascorbic acid) as a prophylactic antioxidant drug. METHODS: 123 adults with 127 conservatively treated wrist fractures were randomly allocated in a double-blind trial to take a capsule of 500 mg vitamin C or placebo daily for 50 days. Each participant's sex, age, side of fracture, dominance, fracture type, dislocation, reduction, and complaints with the plaster cast were recorded, and they were clinically scored for RSD. The follow-up lasted 1 year. FINDINGS: Eight patients were withdrawn after randomisation. 52 patients with 54 fractures (male 22%, female 78%; mean age 57 years) received vitamin C and 63 patients with 65 fractures (male 20%, female 80%; mean age 60 years) received placebo. RSD occurred in four (7%) wrists in the vitamin C group and 14 (22%) in the placebo group 15% (95% CI for differences 2-26). Other significant prognostic variables for the occurrence of RSD were complaints while wearing the cast (relative risk 0.17 [0.07-0.41]) and fracture type (0.37 [0.16-0.89]). INTERPRETATION: This prospective, double-blind study shows that vitamin C was associated with a lower risk of RSD after wrist fractures. Our hypothesis is that this beneficial effect of prophylaxis would be useful in other forms of trauma.

PMID: 10636366 [PubMed - indexed for MEDLINE]
from http://www.ncbi.nlm.nih.gov/pubmed/10636366

And this recent one:
Quote:
Foot Ankle Surg. 2009;15(4):179-82. Epub 2009 Apr 5.
Effect of vitamin C on prevention of complex regional pain syndrome type I in foot and ankle surgery.

Besse JL, Gadeyne S, Galand-Desmé S, Lerat JL, Moyen B.

Université de Lyon, Lyon, France. jean-luc.besse@chu-lyon.fr

BACKGROUND: The public health cost impact of complex regional pain syndrome type I (CRPS I) is considerable in both emergency and scheduled orthopaedic surgery. We proposed to assess the effectiveness of vitamin C in prevention of CRPS I in foot and ankle surgery. METHODS: We carried out a "before-after" quasi-experimental study comparing two chronologically successive groups without (Group I: July 2002-June 2003) and with (Group II: July 2003-June 2004) preventive 1g daily vitamin C treatment. All patients having surgery on the foot or ankle were enrolled, with the exception of diabetic foot cases. Several factors were analysed: sex, age, type of pathology, history of CRPS I, psychological context, tourniquet time, and cast immobilisation time. RESULTS: 420 feet (392 patients) were included in the study: 185 in Group I, 235 in Group II. CRPS I occurred in 18 cases in Group I (9.6%) and 4 cases in Group II (1.7%) (p<10(-4)), with history of CRPS I as a significantly correlated factor (relative risk=10.4). The psychological context (anxio-depressive state) showed a (sub-significant) tendency to increase the risk of CRPS I (relative risk=2.6). CONCLUSION: Vitamin C has been shown to be effective in preventing CRPS I secondary to wrist fracture, but few data are available with respect to foot and ankle cases. The present study demonstrates the effectiveness of vitamin C in preventing CRPS I of the foot and ankle-a frequent complication in our control group (9.6%). The authors recommend preventive management by vitamin C.

PMID: 19840748 [PubMed - indexed for MEDLINE]
The first study used 500mg daily for 50 days. The latter studies, and there are more than I have linked, used also 1000mg/day and 1500mg/day.

If your BIL is a diabetic, careful monitoring of blood sugar while taking high dose Vit C is advised.
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Old 02-16-2010, 07:18 AM #4
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yes today he is having his arms done.After talking with my sis I found out b.i.l. is in gov study for this. He is a vet and having it done at v.a. hosp.
he has other issues too .they think agent orange has caused allot of stuff.
he has no feeling at all in arms or legs. and his short term memory is going down hill.
he has been fitted with wheel chair already for when he has his legs done/
I will share any info as I get it. I think this is pretty new. I believe they go in and move or take out anything that is pressing on or aggravating the nerves. that's what they do with M.V.D. so I guess it is the same only arms and legs.

MrsD yes he is diabetic and also has gout in ankle off and on.
thanks so much for the replies and info.
I love my Neuro talk family.

PEACE
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Old 02-16-2010, 08:40 AM #5
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So he is having decompression of the SPINE? That is different, but do have him bring up the Vit C. They probably won't let him have it, because in studies they control the variables strictly.
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Old 02-16-2010, 09:00 AM #6
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Quote:
Originally Posted by Burntmarshmallow View Post
I believe they go in and move or take out anything that is pressing on or aggravating the nerves.
That is what they did for me - spinal decompression, they called it, and it was, 3 years ago, not a new operation though not common. I had NP in legs, poor bowel control and impaired mobility, cause diagnosed as pressure on spinal nerve from bone spurs, damaged disc etc. The op was successful in some ways but couldn't repair damage to central nerve which had already occurred.
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Old 02-16-2010, 03:02 PM #7
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I have not heard how things went yet.
Today he is having arms they will do like carpel on wrists and also go in by elbows . . . but not spine just arms
and I think for legs it will be spinal decompression but they may also go in at knees and ankle.
Man this is confusing to me and I am sorry for seeming so dense.I know about m.v.d. for trigeminal neuralgia and thats it. Thanks so much for helping me out with replies and info.
I dont understand all the stuff about him being in a gov study perhaps they try something different then usualy or like MrsD mentioned a very strict control of the variables .
I do know he was a gunner on helicopter in Nam and agent orange is playing a big part in all his issues so that is why he is in study and going to va Hosp.
My appreciation and gratitude for the help and chat. low pain and positive thoughts to the forum and the readers here. I hope when this is all done I can give info that will help another person. You are all so great T.Y.

PEACE
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