Progression of peripheral nerve injury in leprosy: Evaluation of the effect of nerve decompression surgery in an endemic region of brazil

Abstract

Aim: To evaluate the progression of nerve injury in leprosy patients undergoing peripheral nerve decompression surgery. Methodology: Observational study of retrospective, descriptive-analytical cohort. In the convenience sample, individuals with leprosy who underwent peripheral nerve decompression surgery at the Casa de Saúde Santa Marcelina, Porto Velho/RO, between 2000 and 2019 were evaluated nerve by nerve, before and after surgery. Results: Note that 574 individuals underwent 2549 surgeries of the ulnar, median, tibial and/or fibular nerves. Most individuals were male (51.6%), of brown race (80.3%), multibacillary (90.9%), aged between 31 and 60 years (73.2%) and originating from other municipalities in the state of Rondônia, Northern Region of Brazil (67.4%). Most individuals maintained or improved the GD (WHO Grade of Disability), the sensory or the motor nerve function in the limbs operated. Conclusion: The improvement or maintenance of the DG was observed in more than 80% of the operated individuals. In the nerve-to-nerve analysis, considering the sensory and motor functions for all operated nerve trunks, there was an improvement or maintenance of the values presented in the preoperative period for most individuals. According to the results obtained in this study, we concluded that peripheral nerve decompression surgery was able to interrupt the progression of nerve injury in more than 80% of the operated individuals. Considering the potential of the surgery as a preventive procedure, we recommend its indication even for individuals with grade 0 of disability but that present persistent pain or neural thickening after four weeks of clinical treatment without other symptoms.