One more domain of neurosurgeons is the nerves outside the brain and spinal cord. These cord-like structures are known as peripheral nerves, and they encounter their own particular problems. Some, like the brachial plexus--the nerves in the shoulder region--are easily injured in car and motorcycle accidents. Others can become painfully entrapped, as in the now-familiar carpal tunnel syndrome. In one common genetic disorder called neurofibromatosis, the nerves even become riddled with tumors. Peripheral nerves are the world of Hopkins neurosurgeons James Campbell and Allan J. Belzberg, who are developing novel ways to deal with these and other problems.
Belzberg, for example, uses an innovative technique to bypass an injured nerve by using a healthy nerve from another part of the body to rewire the system. His patients, many of whom had been told that they faced certain amputation, recover with partial use of the injured limb.
When peripheral nerves are injured, they trry to regenerate. When they fail, they can form painful tangles called neuromas. In the lab, Belzberg has developed a rat model that enables him to evaluate how neuromas form. He then tests new drugs and other techniques to provoke the nerve to rid itself of the neuroma and to stop forming new ones. And in one more unusual study, Belzberg is developing ways to remove or treat the tumors of patients with neurofibromatosis while leaving the nerves intact.
