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TTS Surg; Done by a Neurologist? Ortho?

Posted by EKC on 3/28/02 at 06:51 (077814)

Why / why would you not have a Neurosurgeon do a TTS release?
What about an Orthopaedic Sports doc, especially if the TTS was caused by a sports injury (running, etc)?
What I'm getting at is... do these doctors have better success rates w/this procedure than a podiatrist has?

Re: TTS Surg; Done by a Neurologist? Ortho?

Ed Davis, DPM on 3/28/02 at 19:43 (077895)

Neurologists generaly do not perform surgery. Few neurosurgeons do TTS releases. One notable exception is A. Lee Dellon, MD. There are no documented differentials in success rates based on the type of doctor performing tarsal tunnel surgery.
Ed

Re: TTS Surg; Done by a Neurologist? Ortho?

Dr. David S. Wander on 3/28/02 at 20:52 (077905)

Ed, I believe A. Lee Dellon, MD is actually trained as a plastic surgeon. Regardless, he's got an excellent reputation. I agree, that very few neurosurgeons are performing tarsal tunnel releases, though they are certainly qualified. The majority of TTS is performed by orthopedic surgeons or podiatric surgeons. The choice is naturally up to the patient. However, no matter which specialist you choose, make sure that tarsal tunnel surgery is a procedure that he/she performs on a regular basis, and not once a year. This can be a very tricky surgery, and experience certainly counts. Good luck.

Re: TTS Surg; Done by a Neurologist? Ortho?

EKC on 3/29/02 at 07:13 (077937)

Thanks. I may have the surgery done by Dr. Michael Smith in Orlando FL. He apparently has done many of these.
He has some affiliation w/Dr. Dellon. I know Dr. Smith is trained on the PSSD nerve instrument and EWST.
I asked him for references - the next day two of his patients called me and gave me rave reviews about he and
their surgery-outcomes.
He said that since I am not diabetic, young (38) and healthy, I am a good candidate. Any comments?

Re: TTS Surg; Done by a Neurologist? Ortho?

Barbara on 3/29/02 at 08:28 (077950)

I have been having problems with my right foot for almost a yr. Everything My Dr. has tried has not worked, injections, pills, nightsplints,orthodics,once did a bone scan,stress fracture in ankle area and heel,but in a cast for 1 month, worse when cast was removed. Had surgery Nov 23 2001 or so for Plantar fascities,now is worse. Before I could at least walk,then had a lot of pain and now I have constant pain in right arch, heel ball of foot and toes dumb and tingly. Pain and swollen go up my leg sometime even into my thigh area. Had neurologist do emg and now say tarrsel tunnel. Podiatrist tried a steriod injection and I got no relieve at all. Now going to Orth Surgeon to do surgery as I can't stand this pain, but no gurantees? I don't know what to do? Havn't been working since Dec. can barely get around to do personal things around the house. My work say I should be at work,because I have a desk job, but sitting increases the swolling sensation and the pain in my front inside of my heal by the arch is swollen. The Dr. doing the surgery is suppose to be one of the best (Milwaukee Wi.)in Area, Dr. Dan Guehlsdorf. But I'm afraid nothing is going to work. Before all this happened I was a 4-6 mile walker a day with my dogs,golfed 2-3 times a week with my Husband,now I can do nothing!!!!! I'm only 49yrs old. What is going on why can noone fix this foot problem? So many controversies. I have used antiinflamatories,they have tried Neurontin, injections no relieve. I was diagnosed 8yrs ago with fibromyalgia,has anyone ever contected this with feet trouble? I Need Help!!! Thanks

Re: TTS Surg; Done by a Neurologist? Ortho?

Dr. David S. Wander on 3/30/02 at 12:16 (078045)

EKC,

It sounds like you're in good hands. Your doctor appears to be more than qualified and I like the fact that you've spoken with patients that have had surgery performed by your doctor. Just remember to ask questions if you have any concerns, and follow his post op instructions. I strongly advise all patients to follow the post op instructions of his/her surgeon, and not the advice of well meaning friends, family, etc. Good luck.

Re: TTS Surg; Done by a Neurologist? Ortho?

EKC on 3/31/02 at 06:48 (078084)

Thanks everyone.
TOday, Easter, I can barely walk around the house.
It feels like my fashia is ripping out of all points of
connections in the heel (mid, outside). I don't think I
have much time left to make a decision about surgery.

Re: TTS Surg; Done by a Neurologist? Ortho?

BrianG on 3/31/02 at 20:17 (078126)

If your not ready to make a decsion, ask your doctor for some pain medication. It might buy you some time. It's very hard to make an informed decision, when you are hurting as much as you are at this moment. Good luck

BrianG

Re: TTS Surg; Done by a Neurologist? Ortho?

Ed Davis, DPM on 3/28/02 at 19:43 (077895)

Neurologists generaly do not perform surgery. Few neurosurgeons do TTS releases. One notable exception is A. Lee Dellon, MD. There are no documented differentials in success rates based on the type of doctor performing tarsal tunnel surgery.
Ed

Re: TTS Surg; Done by a Neurologist? Ortho?

Dr. David S. Wander on 3/28/02 at 20:52 (077905)

Ed, I believe A. Lee Dellon, MD is actually trained as a plastic surgeon. Regardless, he's got an excellent reputation. I agree, that very few neurosurgeons are performing tarsal tunnel releases, though they are certainly qualified. The majority of TTS is performed by orthopedic surgeons or podiatric surgeons. The choice is naturally up to the patient. However, no matter which specialist you choose, make sure that tarsal tunnel surgery is a procedure that he/she performs on a regular basis, and not once a year. This can be a very tricky surgery, and experience certainly counts. Good luck.

Re: TTS Surg; Done by a Neurologist? Ortho?

EKC on 3/29/02 at 07:13 (077937)

Thanks. I may have the surgery done by Dr. Michael Smith in Orlando FL. He apparently has done many of these.
He has some affiliation w/Dr. Dellon. I know Dr. Smith is trained on the PSSD nerve instrument and EWST.
I asked him for references - the next day two of his patients called me and gave me rave reviews about he and
their surgery-outcomes.
He said that since I am not diabetic, young (38) and healthy, I am a good candidate. Any comments?

Re: TTS Surg; Done by a Neurologist? Ortho?

Barbara on 3/29/02 at 08:28 (077950)

I have been having problems with my right foot for almost a yr. Everything My Dr. has tried has not worked, injections, pills, nightsplints,orthodics,once did a bone scan,stress fracture in ankle area and heel,but in a cast for 1 month, worse when cast was removed. Had surgery Nov 23 2001 or so for Plantar fascities,now is worse. Before I could at least walk,then had a lot of pain and now I have constant pain in right arch, heel ball of foot and toes dumb and tingly. Pain and swollen go up my leg sometime even into my thigh area. Had neurologist do emg and now say tarrsel tunnel. Podiatrist tried a steriod injection and I got no relieve at all. Now going to Orth Surgeon to do surgery as I can't stand this pain, but no gurantees? I don't know what to do? Havn't been working since Dec. can barely get around to do personal things around the house. My work say I should be at work,because I have a desk job, but sitting increases the swolling sensation and the pain in my front inside of my heal by the arch is swollen. The Dr. doing the surgery is suppose to be one of the best (Milwaukee Wi.)in Area, Dr. Dan Guehlsdorf. But I'm afraid nothing is going to work. Before all this happened I was a 4-6 mile walker a day with my dogs,golfed 2-3 times a week with my Husband,now I can do nothing!!!!! I'm only 49yrs old. What is going on why can noone fix this foot problem? So many controversies. I have used antiinflamatories,they have tried Neurontin, injections no relieve. I was diagnosed 8yrs ago with fibromyalgia,has anyone ever contected this with feet trouble? I Need Help!!! Thanks

Re: TTS Surg; Done by a Neurologist? Ortho?

Dr. David S. Wander on 3/30/02 at 12:16 (078045)

EKC,

It sounds like you're in good hands. Your doctor appears to be more than qualified and I like the fact that you've spoken with patients that have had surgery performed by your doctor. Just remember to ask questions if you have any concerns, and follow his post op instructions. I strongly advise all patients to follow the post op instructions of his/her surgeon, and not the advice of well meaning friends, family, etc. Good luck.

Re: TTS Surg; Done by a Neurologist? Ortho?

EKC on 3/31/02 at 06:48 (078084)

Thanks everyone.
TOday, Easter, I can barely walk around the house.
It feels like my fashia is ripping out of all points of
connections in the heel (mid, outside). I don't think I
have much time left to make a decision about surgery.

Re: TTS Surg; Done by a Neurologist? Ortho?

BrianG on 3/31/02 at 20:17 (078126)

If your not ready to make a decsion, ask your doctor for some pain medication. It might buy you some time. It's very hard to make an informed decision, when you are hurting as much as you are at this moment. Good luck

BrianG