Stony Brook Medicine: Courtney Pendleton, MD, Offers Surgical Solutions for Peripheral Nerve Disorders

By Katy Mena-Berkley
Friday, January 15, 2021

Specialists at Stony Brook Medicine are equipped with extensive training and sophisticated technology to address dysfunction created by peripheral nerve complications.

Peripheral nerve disorders can create a spectrum of complications for patients, causing an array of issues, including weakness, loss of sensation and pain. These disorders commonly occur when a nerve becomes entrapped and endures trauma, which may happen as a result of injury or overuse that causes nerves to become overstretched or severed.

“Nerve trauma can happen to anybody, because it may occur as a result of work accidents, car accidents or motorcycle accidents. They can happen at birth or when a newborn, infant or child has an accident,” says Courtney Pendleton, MD, Assistant Professor of Neurosurgery at Renaissance School of Medicine at Stony Brook University. “It is pretty universal.”

Peripheral nerve complications may also occur when nerve tumors develop, which can happen to anyone. However, patients who have certain genetic conditions, such as neurofibromatosis or schwannomatosis, are more likely to experience nerve tumors.

In the case of either nerve trauma, tumor or entrapment, neurosurgery specialists at Stony Brook Medicine, led by Dr. Pendleton, can offer patients a wealth of surgical solutions to address peripheral nerve disorders, restore function and sensation, and enhance overall quality of life.

The Importance of Early Intervention

While some patients may be tempted to ignore peripheral nerve dysfunction for a period of time, not identifying and treating the issue early may cause irreversible damage. Specifically, if a patient is experiencing weakness in a muscle as a result of peripheral nerve damage, muscle strength will not return until the nerve is fixed. If a patient has a nerve injury that is causing numbness, tingling or burning pain, that discomfort will continue until the pressure on the nerve is relieved or the severed nerve is repaired.

“Whether you have a peripheral nerve issue like carpal tunnel or a nerve tumor, addressing it early can be likened to having heavy furniture on carpet,” Dr. Pendleton says. “If you have the heavy furniture on the carpet for a day and you move it, the carpet is fine. If you have the heavy furniture on a carpet for a year, it takes a long time for the marks in the carpet to go away. And sometimes they do not, and the nerves are like that. If you fix them right away, there is a better chance that they get better and that they get better completely.”

“Injuries or issues with peripheral nerves can be under-recognized. At Stony Brook Medicine, we have the infrastructure that is required to make accurate diagnoses and provide patients with the treatment they need.”
— Courtney Pendleton, MD, Assistant Professor of Neurosurgery, Renaissance School of Medicine at Stony Brook University

Sophisticated Diagnostics

Critical to the successful treatment of peripheral nerve disorders is an accurate diagnosis of the factor causing the complication in each patient.

“If someone comes in, and it is unclear if they have a spine issue or something else entirely, they need imaging,” Dr. Pendleton says. “It is important to be able to provide that service consistently and in-house … Having that available to us here at Stony Brook Medicine is very convenient both for the patients and for our clinical decision-making. We have a very special setup here.”

In addition to MRI, the diagnostic team may perform ultrasound to visualize the nerves and look for tumors inside of them. The neurology professionals may also conduct diagnostic electromyography (EMG) to study how signals travel down the nerves into the muscles.

“An EMG can give us a lot of really important information about what problem a patient has and what treatment they might need,” Dr. Pendleton says. “Our neurology team does a great job with these tests, providing patients with the answers necessary to make treatment decisions.”

Tailored Treatment Plans

Each patient’s unique condition will determine whether surgery is necessary to address peripheral nerve dysfunction. In some instances, nerve pain can be treated with medications and physical therapy.

“Our neurologists, pain management specialists and physiatrists do a great job with nonoperative treatments to address nerve pain, and medications can help,” Dr. Pendleton says. “But if people are having numbness, prickly tingling or weakness, it is time to talk about potentially having surgery to either fix the nerve if it is damaged, or decompress the nerve if it is stuck. We may also need to take out a tumor if that is what is causing the problem. Those are all procedures that I have trained to do and perform in my practice.”

In the event that a more complex operation is required, Dr. Pendleton has the ability to collaborate with a large network of specialists at Stony Brook Medicine, including plastic surgeons, orthopedic surgeons and/or general surgeons to reach nerves that are located in hard-to-access areas of the body.

“We have a great team here helping me get safely to where the nerves are,” Dr. Pendleton says. “What I bring to the table is my training as a neurosurgeon in peripheral nerve surgery. So I am one of the last pieces added to the team to really help expand what we at Stony Brook Medicine are able to offer patients with these kinds of nerve problems.”

If while working up a patient with a peripheral nerve lesion, Dr. Pendleton discovers a malignant nerve tumor, she will collaborate further with a large team that may include oncologists, general surgeons and vascular surgeons.

“We have all of the components in place here at Stony Brook Medicine,” Dr. Pendleton says. “We are in a unique position to offer a very well-trained and highly specialized neurosurgery specialty to the Long Island community extending all the way up into the Connecticut shoreline.”

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