Ultrasound-Guided Surgery Success

Many are aware of NMRF’s research on ultrasound-guided surgery for carpal tunnel syndrome, with the fastest and best documented recovery for this problem. This type of ultra-minimally invasive surgery, wherein “the camera” remains outside the body, can be applied to other nerve compression syndromes. In the case of Rebecca Oberschulte, Dr. Bodor devised a technique similar to the one he uses for carpal-tunnel syndrome to treat her chronic leg pain.

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"Now I don't have any pain. None. And that pressure and tightening- it's gone."

Since 1990, Oberschulte suffered from intermittent exercise-induced extreme pain in one of her legs from Chronic Exertional Compartment Syndrome, which is most commonly seen in elite athletes. In this condition, the fascia in the leg which surrounds muscles, tendons, and nerves becomes too tight. “It’s like a sausage in which the casing is very tight,” says Dr. Bodor.  “When I exercised and the muscles expanded, it felt like major pressure in my leg… like if you had one of those blood pressure cuffs on it,” explains Oberschulte.  “It also crimped down on the nerves so much that my foot went to sleep and I couldn’t walk.” Dr. Bodor was able to make small incisions in Rebecca’s leg, then using ultrasound, pass a special knife inside to release the fascia, relieving the pressure on the muscles and nerves. 

The type of surgery usually performed for this syndrome is much more involved, requiring the surgeon to incise the full length of the compartment from ankle to knee. Up until now, the most advanced technique (done at Duke University), has been arthroscopic. The recovery time with this approach takes at least a month. By contrast, Oberschulte reports she was mobile and pain-free within two days.

 

Dr. Bodor was confident he could help Rebecca because he had done the same procedure on a top UC Berkeley athlete 7 years ago. “This technique, which is performed in the office with local anesthesia, is a first to my knowledge,” explains Bodor.

 

Dr. Bodor and Oberschulte are thrilled with the outcome. Yvette Uribe, BA and Dr. Bodor measured the pressure in her leg before and after the procedure and it went from 24 mmHg (elevated) to 15 mmHg (normal). “Now I don't have any pain. None. And that pressure and tightening- it's gone,” says Oberschulte. “I’m taking really long hikes now. We went down to Pismo Beach and we walked and walked and it doesn't bother me at all. And my toes aren't asleep all the time.”

 

Currently, the NMRF research team is using Oberschulte as a case study and tracking her progress for a future publication on this technique.

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