An analysis of the role of targeted muscle reinnervation(TMR)in quality of life and pain outcomes:a case series
作者机构：Department of Plastic SurgeryRoyal Free HospitalPond StreetLondon NW32QGUnited Kingdom
出 版 物：《Plastic and Aesthetic Research》 (整形与美容研究（英文版）)
年 卷 期：2023年第10卷第1期
页 面：663-669页
主 题：Amputation TMR targeted muscle reinnervation quality of life QALY
摘 要：Aim:Targeted muscle reinnervation(TMR)surgery has fundamentally changed the management of patients who have suffered or are about to undergo *** nerve stumps with a muscle target has been shown to have profound effects on levels of post-amputation pain in relation to phantom limb pain(PLP)and neuroma pain(NP).The primary objective of this report was to quantify pain parameters for this population and to measure the impact on health-related quality of life(HRQol)before and after TMR *** this case series,we evaluate the role of TMR in addressing both pain and the impact of the surgery on the patient’s quality of ***:A retrospective analysis of 15 upper limb amputee patients who underwent TMR by the Relimb Unit in London,***’perceptions of pain were determined using the 11-point numerical(Pain)rating scale(NRS)and HRQoL was calculated using the Euroqol EQ-5D-5L questionnaire at two time points,comparing both pain and perceived quality of life pre and post *** Wilcoxon Signed Rank Test was used for the NRS data and a paired sample t-test was used for the EQ-VAS ***:A total of 15 patients completed the *** observed statistically significant reductions in both PLP(pre-operative mean:7.6,post-operative mean:2.7,P0.05)and NP(pre-operative mean:6.4,post-operative mean:2.5,P0.05)in these ***,HRQoL observed on the EQ-VAS scale demonstrated a significant improvement in quality of life,from 68 pre-operatively to 78 post-procedure(P0.05).Conclusion:This is the first quantified evaluation of changes in HRQoL after TMR surgery for upper limb *** appears to be a significant improvement in both HRQoL and overall perception of *** finding may have important implications for funding and national resource allocation for TMR surgery.
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