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Efficacy Of Targeted Muscle Reinnervation And Regenerative Peripheral Nerve Interface In Reducing Pain In Cancer Amputees: A Patient-reported Outcomes Study
Rami Elmorsi, MD, Ashley Shin, BS, David M. Adelman, MD, Alexander F. Mericli, MD, Margaret J. Roubaud, MD.
MD Anderson Cancer Centre, Houston, TX, USA.
PURPOSE: Targeted muscle reinnervation (TMR) and regenerative peripheral nerve interface (RPNI) outcomes in oncologic amputees are mostly limited to small case series. This is the first comparative analysis of patient-reported outcomes between TMR/RPNI and no-TMR/RPNI oncological amputees.
METHODS: We conducted a retrospective cohort study of patients who had oncologic amputations between 2018-2024. We collected Numerical Rating Scale scores for residual limb pain (RLP), phantom limb pain (PLP), and Patient-Reported Outcomes Measurement Information System (PROMIS) data for pain intensity, pain interference, and pain behaviors.
RESULTS: We analyzed 55 TMR/RPNI and 33 non-TMR/RPNI responses. Albeit the significantly shorter elapsed postoperative period for TMR/RPNI patients (381 vs. 1743 days,
p<0.001), they reported significantly lower mean RLP (0.6 vs. 2.5,
p<0.001), PLP (1.2 vs. 3.0,
p<0.001), pain intensity (5.4 vs. 7.6,
p<0.001), pain interference (13.6 vs. 17.8,
p=0.038), and pain behavior scores (29.7 vs. 48.2,
p<0.001), as shown in figures.
CONCLUSION: TMR/RPNI significantly reduce post-amputation pain across multiple domains in oncologic amputees within a significantly shorter timeframe.
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