Persistence of symptoms after surgical release of compressive neuropathies and subsequent management

Persistent symptoms following release of a compressive neuropathy may be the result of the wrong diagnosis, inadequate decompression, iatrogenic compression, double-crush syndrome, or end-stage disease. Management of the patient requires careful re-examination of all available data to arrive at a correct diagnosis while ruling out other elements of the differential diagnosis. Revision surgery is indicated only with a confirmed diagnosis. Revision surgery must relieve residual nerve compression, maintain or enhance neurovascularity, prevent neuritises, and provide protective padding of the entrapped nerve.