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Neuroma Decompression procedure.

Posted by Dr. Z on 3/06/04 at 04:48 (146191)

Dear doctors/posters,
Has any doctor or patient used or been treated with a procedure called MIND . Minimally Invasive Neuroma Depression. This is a surgical alternative for excision of a morton neuroma I would like your experience with this procedure whether as patient and or doctor. Thanks in advance

Re: Neuroma Decompression procedure.

Dr. David S. Wander on 3/06/04 at 07:13 (146194)


I believe you meant to write 'decompression', not depression (by now we're all aware of your typing skills!) I believe there are several ways to perform this procedure. There is an endoscopic decompression, created by the original EPF group (called the EDIN procedure), and there is new instrumentation developed by Isogard that is used for plantar fasciotomies and nerve decompression without the use of an endoscope. The procedure, whether performed endoscopically or with the newer Isogard instrumentation, simply is a release of the deep transverse metatarsal ligament to 'decompress' the nerve. I believe that the Isogard system accomplishes the same end result as the endoscopic procedure without the expense of the use of endoscopic equipment and without the need for multiple 'ports' of entry.

Re: Neuroma Decompression procedure.

JudyB on 3/06/04 at 11:04 (146207)

Sorry, not a patient here, but if I can ask...Does this procedure render the foot less stable?

Re: Neuroma Decompression procedure.

Dr. Z on 3/06/04 at 12:02 (146219)

Thanks David

I am very familiar with the procedure what is your personal experience with this procedure. I first saw this procedure performed by a Dr. Edwin Probber in 1970. I believe he would call it a ligotectomy. It has again become very popular again so that is why I am asking about it .
I am looking for doctor-patient experience.

Re: Neuroma Decompression procedure.

Dr. Z on 3/06/04 at 12:04 (146220)

It could make the metatarsal bone go into a plantarflexed position. I have corrected two cases where a patient had a neuroma excision and the bones dropped. I am not sure why this happen but it could be from the cutting of this ligament So yes it might make that area less stable for a period of time or forever

Re: Neuroma Decompression procedure.

Rose on 3/07/04 at 18:12 (146387)

Yes, I had this procedure last July 1. I had a PF release on the other foot at the same time. I ws given the option of three types of surgery for the neuroma. The doctor recommended cutting the ligament. He cut about an inch incision on the top of my foot between the 3rd and 4th toes. It healed very quickly and is fine after 7 months, although I occasionally feel it a little bit. I would appreciate any information you have on this. Since I am starting to feel the neuroma a little now and not until the last month, does this mean it might come back as before?

Re: Neuroma Decompression procedure.

Lauren, PMAC on 3/09/04 at 20:39 (146577)

Dr. Z,

At our office, we perform both the KOBY Minimally Invasive Nerve Decompression for neuromas and the KOBY Minimally Invasive Plantar Fasciotomy. Several months ago, I arranged for Perry Forrester, who designed the Isoguard instruments, to perform a cadaveric workshop at our office with my doctor and several others. We have had FANTASTIC results with both the MIND and MIPF procedures, as the post op recovery is less demanding for the patient and doctor. We found the MIND procedure to be far superior to the EDIN procedure as well. We have even performed the MIND procedure on patients who have had previous neuroma surgery without luck. My doctor also loves the 'foolproof' instruments for the procedure. If you have any questions, feel free to contact me.


Re: Neuroma Decompression procedure.

Dr. Z on 3/09/04 at 20:48 (146578)

Hi Lauren,

The MIND procedure with the Koby procedure is the exact procedure that I am talking about. I have seen the procedure via CD ROM and reviewed the results. I would like much to see this procedure on a cadaveric specimen. It sounds like a VERY promising procedure. The Instructs do look fool proof and the cost of instrumentation very reasonable. Would you mind contacting me at (email removed)

Re: Neuroma Decompression procedure.

Pauline on 3/10/04 at 21:37 (146643)

Nice website to explain these procedures to laypeople.

Re: Neuroma Decompression procedure.

Chris C. on 3/28/05 at 15:59 (172068)

The KOBY Minimally Invasive Nerve Decompression for neuromas sounds very promising. Is there a doctor skilled in this procedure in the DC/Baltimore/Annapolis area? Thanks.

Re: Neuroma Decompression procedure.

Darlene on 3/28/05 at 19:03 (172081)

I had this procedure and it was a nightmare. Not only was the neuroma pain so much worse, the doc injured the 2nd webspace in the process. My new pod said that he would never do this procedure - i.e. blind surgury right near a nerve. He also said that the older and bigger the neuroma, the less likely it will be successful. As part of your homework, you may want to check with a local ortho to get their opinion on this procedure.