Dr. Dumanian has performed groundbreaking work in the treatment of amputee pain and phantoms. He created Targeted Muscle Reinnervation for improved control and function of upper extremity prosthetics. The first person to undergo this was Mr. Jesse Sullivan, who had the surgery procedure in 2002. With just thinking, after the surgery he could move his bionic arm. Over time, Dr. Dumanian and his team noticed that patients had improved pain and phantoms after the TMR surgery, and this was written up in 2014. Dr. Dumanian then received a led a multicenter clinical trial for amputees that demonstrated improved symptoms with the Targeted Muscle Reinnervation procedure. The trial showed that TMR helped phantoms and pain at the final follow up of the patients, while standard nerve surgery was of no significant benefit. More recently, Dr. Dumanian along with Dr. Ian Valerio of The Ohio State University has performed this surgery at the time of amputation as a PREVENTION technique against amputee-related pain and phantoms.
It is unclear what causes phantom sensations. It is believed that the brain “misses” the inputs of nerves from the periphery. TMR gives the nerves “somewhere to go and something to do”. Perhaps the improvement of phantoms is due to the brain once again getting normal signals from the periphery. In terms of end-nerve pain, in laboratory animals TMR has been shown to cure neuromas, by reversing the trend of the axons to sprout and become smaller. Dr. Dumanian believes that the healing of the end of the nerve with TMR nerve transfers is what causes the improvement in phantoms and local pain in amputees.
CV & Publications
- Bionic Arm Videos/Articles
- Bionic Arm in patient with transhumeral amputation: an amputation above the elbow.
- Bionic Arm in patient with shoulder disarticulation: an amputation at the shoulder.
- Video of transhumeral TMR surgical procedure
- Article: Bionic Arms, Controlled by the Brain – (Photos)
- Additional Resources
- The Rehabilitation Institute of Chicago has articles from medical journals describing the procedure, and videos of some of our patients.
- Wikipedia entry on targeted muscle reinnervation
- New York Times article on targeted muscle reinnervation
- Targeted Muscle Reinnervation Articles by Dr. Dumanian
- Targeted muscle reinnervation and prosthetic rehabilitation
after limb loss - Lancet Targeted Innervation
- New Yorker
- Targeted Muscle Reinnervation for Transhumeral Amputees
- Targeted muscle reinnervation in the initial management of traumatic upper extremity amputation injury
- Targeted muscle reinnervation and upper limb amputation
- Targeted Muscle Reinnervation and Advanced Prosthetic Arms
- Targeted Muscle Reinnervation: A Novel Approach to Postamputation Neuroma Pain
- Risks and Benefits of Transplantation
- Targeted Muscle Reinnervation in the Lower Leg
- Hernia
- Sutures and Meshes
- General Reconstruction
- Thighplasty for Prosthetic Function
More about Dr. Dumanian
Dr. Dumanian is a surgical innovator and the first to perform targeted muscle reinnervation. He also is the developer of Mesh Suture. The open mesh design distributes forces to prevent the suture from tearing through tissues in abdominal wall surgery and orthopedics. Dr. Dumanian is also recognized for his work in rectus diastasis / abdominal hernia surgery. To learn more, or to schedule a consultation, contact Dr. Dumanian at 312-695-6022.