Treatments

About Our Treatments

We offer a wide variety of procedures designed to restore form and function to patients who have suffered from disfiguring or disabling diseases and trauma.

Following are just a few of the advanced reconstructive surgery techniques, we offer:  

Brachial Plexus Reconstruction
Traumatic injuries such as car accidents, motorcycle accidents, and boating accidents can often lead to nerve injuries to the brachial plexus. The brachial plexus is the network of nerves in the armpit that control all the functions of the arm and hand. The reconstructive surgery required to correct these injuries is complex and time-consuming, and it requires an incredible understanding of the anatomy and physiology of this complicated area of the body.  

Our doctors are experts in this advanced reconstructive surgery technique. In addition to standard brachial plexus reconstruction, we have performed 9 nerve transplants for massive brachial plexus injuries that could not be reconstructed with standard techniques.  

Nerve Transplantation
Only eleven nerve transplants have been performed in the world, and nine of those were done right here in New Jersey by our physicians. With this advanced reconstructive surgery technique, our surgeons are able to restore function to people who have lost the use of several nerve trunks in the arm or leg nerve plexuses. We draw upon a local team of experts in neurology,immunology, transplant medicine, and infectious diseases to make this complex reconstructive surgery procedure proceed smoothly and assure the best possible outcomes.  

Nerve Reconstruction for Phrenic Nerve Injury
The phrenic nerve controls function of the diaphragm muscle - the primary muscle involved in breathing. Contraction of the diaphragm muscle permits expansion of the chest cavity and inhalation of air into the lungs.  

Injuries to the phrenic nerve cause paralysis to one or both sides of the diaphragm, resulting in some degree of breathing difficulty. In its mildest form, phrenic nerve injury will cause shortness of breath with exertion, whereas more severe injuries will result in the need for oxygen therapy or even a respirator.  

We offer groundbreaking surgical treatments for phrenic nerve injury. Using nerve reconstruction techniques we have been able to successfully restore function to the diaphragm in patients with phrenic nerve injuries.  

Diaphragm Pacemaker for Ventilator Dependency
After cervical spinal cord injury many patients require a ventilator to help them breathe. There are serious consequences of ventilator dependency, including risks of life threatening infection and even death. In addition, there are significant quality-of-life issues related to being confined to a ventilator.  

We are one of only a few centers in the country that performs the procedure to implant a diaphragm pacemaker.  

A diaphragm pacemaker allows select patients with spinal cord injury to breathe independently, without the need for long term ventilator support. Our doctors have pioneered minimally invasive approaches for implantation of a diaphragm pacemaker, and have developed ground-breaking nerve reconstruction procedures to help patients who would otherwise not be candidates for the diaphragm pacemaker.  

Nerve Decompression Reconstructive Surgery for Peripheral Neuropathy
Peripheral neuropathy is a leading cause of amputations in our country. People with peripheral neuropathy have decreased sensation in the extremities and are, therefore, prone to wounds that become infected and then require amputation. Peripheral neuropathy has many causes, the most common of which is diabetes. The symptoms of neuropathy include pain, numbness, tingling, and loss of strength in the affected arm or leg. In severe cases, it can lead to amputation of the toe, foot, or even the leg. In most cases, the symptoms are due to the diseased nerves being compressed, or "pinched," at known, predictable points along the leg or arm.  

Our doctors are pioneers among their peers in treating neuropathy with reconstructive surgery. This procedure consists of decompressing the "pinched" nerves in the leg or arm. The incisions are very small, pain is minimal, and the procedure is done as an outpatient in most cases.  

Results of this reconstructive surgery are usually dramatic and patients often experience relief in the recovery room! While pain relief is an important goal of this reconstructive surgery, reducing the risk of wounds that lead to amputation is most critical. By improving sensation in the feet and hands, a patient is far less likely to sustain non-healing wounds. In fact, few, if any, patients treated with this technique ever develop a wound or need an amputation. Thus, the procedure protects the patient from future problems from their neuropathy.  

Pressure Sores
Recurrent pressure sores in individuals with spinal cord injury become very difficult to treat unless sensation can be returned to areas where the pressure sores are located. In the past the idea of recovering sensation in paralyzed individuals was believed impossible.  

Our doctors are performing a groundbreaking procedure intended to restore sensation to the hip and buttock areas in paraplegics with recurrent pressure sores. Nerve grafting is performed in conjunction with flap surgery to treat the pressure sore and provide the opportunity for sensory recovery.  

Spinal cord injury often results in paralysis and loss of sensation to portions of the body. Individuals may lose sensation to the lower body and are therefore unable to detect when there is excessive pressure in these locations while sitting in a wheelchair or lying in bed. Over time, this problem progresses from skin breakdown to open wounds, and even to life threatening infections of the underlying bone.  

Surgical treatment is sometimes necessary to clean and cover the wounds. Reconstruction of these wounds is often performed using flap surgery – healthy skin and muscle from nearby locations is mobilized to cover the areas where pressure sores are located.  

Nerve Reconstruction Treatment for Swallowing Disorders
After a stroke many patients find it difficult to eat normally due to swallowing problems. The process of swallowing is rather complex, requiring the precise coordination of various muscles triggered by sensory feedback.  

A stroke may cause an imbalance in this process and can lead to aspiration - the leakage of food and/or saliva into the breathing passages. If left untreated aspiration will often lead to life threatening conditions such as pneumonia. Individuals suffering from stroke and aspiration often have little hope and may be reliant on a feeding tube for nutrition. Until now there have been few options for reversing swallowing difficulties associated with stroke.  

We offer an innovative surgical procedure to select stroke patients. The goal of the procedure is to restore sensation to the upper airway so that stroke patients may protect their airway during swallowing and reduce or eliminate aspiration. Ultimately, the patient would then be able to return to an oral diet rather than a feeding tube for nutritional requirements, thereby improving function and quality of life following stroke.