Multiple nerve entrapements

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Faith
Posts: 697
Joined: Fri Oct 15, 2010 5:15 pm

Multiple nerve entrapements

Post by Faith »

What PN surgeons (or other surgeons) address other nerves than just the PN? Such as the posterior femoral cutaneous nerve, obturator, etc. I know Dellon does and Conway does obturator, right? And then the new hip surgeon in OK, Dr. Martin. Is that all that we know of?

Who would you even go to if you think you have PFCN involvement? (other than Dellon)
-11/08 vulvodynia began around conception of first & only pregnancy
-3/10 sacral/sitting pain began after SIJD manipulation
-Progressive widespread pain- central sensitization
-PT, meds, injections, botox, ESWT = debilitated.
-5/12 Potter MRI - scarring of left ST, coccygeous & posterior alcock
-12/12 - left FAI/labral hip tear surgery
2014-2019 managed w/ gabapentin, massage, and lifestyle mod
2020 - big flare up
www.thepurposeofpain.blogspot.com
paulette
Posts: 184
Joined: Sun Sep 19, 2010 6:13 pm

Re: Multiple nerve entrapements

Post by paulette »

Faith,
I would go to Dr. Martin, because he can look around with his endoscope and check out several nerves at once. He can also attack any scar tissue he finds along the way. Keep us posted!
AliPasha1
Posts: 739
Joined: Fri Sep 17, 2010 2:35 pm
Location: New Orleans,Louisiana

Re: Multiple nerve entrapements

Post by AliPasha1 »

Hi Fith and Paulette,

We have to find other surgeons other than Dr. Dellon who can address the Posterior Femoral Cuatanoeus Nerve,Inferior Cluneal nerve and Obturator nerve.

How are you doing after your surgery with Dr. Conway Paulette.

Kind Regards,
Ali
Diagnosed for PNE by Dr. Jerome Weiss in June 2007.Started PT with Amy Stein in NYC.
PT for almost 3 years now without any results.
Pudendal Nerve blocks in August,2007 by Dr. Quesda left me with sitting pain.
Unilateral TIR approach with Dr. Bautrant on 18 Febuary,2010 with no major improvements and sitting is much worse.
MRI By Dr. Potter reveals nerve entrapment in the ST,AC and DN.
Dorsal Nerve Decompression surgery on April 8,2011
Redo surgery by Dr. Hibner on July 18,2011
nyt
Posts: 1165
Joined: Sun Oct 31, 2010 3:24 am

Re: Multiple nerve entrapements

Post by nyt »

Dr. Howard does obturator nerve, the group in France dose obturator, there was a physician in New Orleans who did obturator (can't remember his name) but I think he has retired. I think the group in France also does cluneal nerve. I'm sure there are other dr.'s who do the obturator nerve. We should start compiling a list of dr.'s who do decompressions of the other nerves so we have options for 2nd opinions and surgery.
2/07 LAVH and TOT 7/07 TOT right side removed 9/07 IL, IH and GN neuropathy 11/07 PN - Dr. Howard
6/08 Obturator neuralgia - Dr. Conway 11/08 Disability, piriformis syndrome - Dr. Howard
4/09 Bilateral obturator decompression surgery, BLL RSD - Dr. Howard
9/10 Removed left side TOT, botox, re-evaluate obturator nerve - Dr. Hibner
2/11 LFCN and saphenous neuralgia - Dr. Dellon 2/11 MRI with Dr. Potter - confirmed entrapment
5/11 Right side TG - Dr. Hibner 2012 Left side TG - Dr. Hibner
AliPasha1
Posts: 739
Joined: Fri Sep 17, 2010 2:35 pm
Location: New Orleans,Louisiana

Re: Multiple nerve entrapements

Post by AliPasha1 »

Hi Nyt,

I completely agree with you that we have to find other doctors who do these respective nerves and take insurance and bring them to the forum.

How are you feeling these.Have you noticed any improvements from Dr. Hibner's surgery as yet?

Kind Regards,
Ali
Diagnosed for PNE by Dr. Jerome Weiss in June 2007.Started PT with Amy Stein in NYC.
PT for almost 3 years now without any results.
Pudendal Nerve blocks in August,2007 by Dr. Quesda left me with sitting pain.
Unilateral TIR approach with Dr. Bautrant on 18 Febuary,2010 with no major improvements and sitting is much worse.
MRI By Dr. Potter reveals nerve entrapment in the ST,AC and DN.
Dorsal Nerve Decompression surgery on April 8,2011
Redo surgery by Dr. Hibner on July 18,2011
User avatar
Karyn
Posts: 1655
Joined: Fri Sep 17, 2010 12:59 pm
Location: Lowell, MA

Re: Multiple nerve entrapements

Post by Karyn »

paulette wrote:Faith,I would go to Dr. Martin, because he can look around with his endoscope and check out several nerves at once. He can also attack any scar tissue he finds along the way. Keep us posted!
Would you consider Dr. Martin, Faith?
Ultra Sound in 03/08 showed severely retroverted, detaching uterus with mulitple fibroids and ovarian cysts.
Pressure and pain in lower abdomen and groin area was unspeakable and devastating.
Total lap hysterectomy in 06/08, but damage was already done.
EMG testing in NH in 04/10 - bilateral PN and Ilioinguals
3T MRI at HSS, NY in 09/10
Bilateral TG surgery with Dr. Conway on 03/29/11. Bilat ilioinguinal & iliohypogastric neurectomy 03/12. TCD surgery 04/14.
Faith
Posts: 697
Joined: Fri Oct 15, 2010 5:15 pm

Re: Multiple nerve entrapements

Post by Faith »

Karyn wrote:Would you consider Dr. Martin, Faith?
I don't know Karyn. I don't understand how he can visualize the entire PN from laproscopic incisions on the side of the hip. I think he is "on to something", but I'd like to see some published research from him on the PN. I know he is an excellent hip surgeon though. None of his patients I've talked to on here have really been able to answer my questions concerning his decompression of the PN.

Considering my history PNE makes much more sense. I think maybe the pain I am feeling around my ischial tuberosities is referred pain from the PN and from muscle spasms (thanks to the botox) from the adductor and hamstring muscles. Because why would I just all of a sudden develop Inferior cluneal nerve entrapement after dealing with symptoms of PN for almost 3 years? I'm awaiting a call back from Hibner to address these issues. I like Hibner's approach to central sensitization as well with this new pain doctor. I definitely have central sensitization issues/CRPS.
-11/08 vulvodynia began around conception of first & only pregnancy
-3/10 sacral/sitting pain began after SIJD manipulation
-Progressive widespread pain- central sensitization
-PT, meds, injections, botox, ESWT = debilitated.
-5/12 Potter MRI - scarring of left ST, coccygeous & posterior alcock
-12/12 - left FAI/labral hip tear surgery
2014-2019 managed w/ gabapentin, massage, and lifestyle mod
2020 - big flare up
www.thepurposeofpain.blogspot.com
User avatar
Karyn
Posts: 1655
Joined: Fri Sep 17, 2010 12:59 pm
Location: Lowell, MA

Re: Multiple nerve entrapements

Post by Karyn »

Faith wrote: I don't understand how he can visualize the entire PN from laproscopic incisions on the side of the hip.
That's because not all of his "port holes" are on the side of the hip.
Faith wrote:None of his patients I've talked to on here have really been able to answer my questions concerning his decompression of the PN.
Well, they probably don't know. It's great to get feedback from his patients about recovery and results, but you may be able to get more definitive answers about his approach by speaking with Dr. Martin directly. Your post is titled: Multiple Nerve Entrapments. I don't know how many "just PN decompressions" he's done. I am aware of him surgically addressing multiple nerve entrapments: PN, Piriformis, Sciatic ...

I wish you the best with Dr. Hibner! :)
Ultra Sound in 03/08 showed severely retroverted, detaching uterus with mulitple fibroids and ovarian cysts.
Pressure and pain in lower abdomen and groin area was unspeakable and devastating.
Total lap hysterectomy in 06/08, but damage was already done.
EMG testing in NH in 04/10 - bilateral PN and Ilioinguals
3T MRI at HSS, NY in 09/10
Bilateral TG surgery with Dr. Conway on 03/29/11. Bilat ilioinguinal & iliohypogastric neurectomy 03/12. TCD surgery 04/14.
User avatar
helenlegs 11
Posts: 1779
Joined: Fri Sep 17, 2010 9:39 am
Location: North East England

Re: Multiple nerve entrapements

Post by helenlegs 11 »

Dr Martin has done at least one endoscopic 'just' pudendal decompression, although I know this was as a follow up op after a piriformis/sciatic decompression. He is newer to this but has waited to research the problem before he decided he was ready to decompress this nerve.
He has done quite a lot of piriformis with sciatic decompression surgery with success but one of his patients was presenting with what he decided were more than piriformis and sciatica symptoms.He was sure that she also had some pudendal involvement.
She had sent in her scans and other reports (Hollis potter and Filler) to him before her appointment and was scheduled for piriformis surgery. At her clinical exam Dr Martin became more sure that her pudendal nerve was involved and re schedule her surgery until he was sure he could address that decompression as well as the sciatic nerve, at the same time.
Her P nerve was found to be adhered to the bone near her ischeal spine (if I remember correctly)
She doesn't post on here very often as she is the (lone) moderator of the yahoo piriformis site but she seems to be doing well post surgery.
Fall 2008. Misdiagnosed with lumber spine problem. MRN June 2010 indicated pudendal entrapment at Alcocks canal. Diagnosed with complex variant piriformis syndrome with sciatic, pudendal and gluteal entrapment's by Dr Filler 2010.Guided piriformis botox injection 2011 Bristol. 2013, Nerve conduction test positive; new spinal MRI scan negative, so diagnosed for the 4th time with pelvic nerve entrapment, now recognised as Sciatic, pudendal, PFCN and cluneal nerves at piriformis level.
paulette
Posts: 184
Joined: Sun Sep 19, 2010 6:13 pm

Re: Multiple nerve entrapements

Post by paulette »

Ali,
You asked how I was doing since my PN surgery. I was doing really well until I started pushing myself and not resting at all during the day. Then I would rest, and as soon as I started feeling better, I would over do again. Now I feel pretty rough. I have got to learn to listen to my body and not push beyond what is wise. It is hard for me to lie down all the time, because my fused spine protests.
I continue to have pretty severe sitting pain, which I guess it to be expected. My rt. heel is still numb, and a new symptom appeared today. The back of my thigh is tender when pressure is applied. I think it is due to extremely tight hamstrings. For three years I have been taking one step at a time to avoid irritating the nerve. So a couple of days ago, I took a couple of steps the normal way. It stretched the hamstrings but didn't seem to irritate the nerve. That is such a little thing, but I am excited! The numbness may be due to the PFCN. I talked to Dr. Dellon the day before my surgery. He felt my numbness was a symptom of PFCN.
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