We are all afraid of the unknown and so Dr Steven Goldstein has kindly answered the questions we all want to know, regarding Cryosurgery for TTS.
Questions asked by Helen Kotonias, Answers by Dr Steven Goldstein, DPM, DABPS, FAPWCA.
Q. What is Cryosurgery?
A. Cryosurgery is the use of extremely cold temperature to freeze peripheral nerves with nitrous oxide for sensory nerve pain.
Q. How long does the procedure take for TTS?
A. It takes approximately ½ hour from start to finish.
Q. Would I be awake for the procedure?
A. Yes it is important to be awake to know if we are touching the PT nerve.
Q. If the posterior tibial nerve is a mixed nerve both sensory and motor, how can you be sure you are not causing damage to the motor component of the nerve when performing cryosurgery?
A. Cannot give a scientific answer here but my take is the following, we are treating the PT nerve at its trifurcation where the nerves are sensory so I assume the PT nerve is more sensory here than motor. Collectively about 50 procedures have been performed to date without motor loss. We are only freezing a very small portion of a large nerve so we are not causing a lot of destruction.
Q. Is it possible to loose the motor function to the foot by freezing this nerve?
A. We do not no for sure.
Q. How long have you been performing Cryosurgery for TTS?
A. 1 and ½ years.
Q. How many TTS ops have you performed to date?, and what is your success rate?
A. I have performed 19 so far with 70% success rate of alleviating symptoms.
Q. Would you mind putting us in contact with sufferers who have had Cryosurgery for TTS?
A. This could be arranged but due to HIPPA regulations I cannot divulge the names over the site.
Q. Can Cryosurgery work on failed open surgeries?
A. I have already performed this on failed TTS surgeries.