Nerve 'mapping' will make surgery safer

An imaging technique providing surgeons with a 'map' of nerves in the body will lead to safer and faster operations by reducing damage to healthy tissue, doctors said yesterday.

The technique will also help people with unexplained backpain, which is difficult to treat, by giving doctors, for the first time, an image of the nerves responsible. In addition, patients who suffer severe pain and paralysis because of nerve compression which cannot be located will benefit from the technique.

Professor John Griffiths, from St George's hospital, London, who developed the technique, known as neurography, with colleagues at the University of Washington, Seattle, said that it could soon be in routine clinical use in a wide range of cases. Surgeons would obtain nerve maps of the areas they were to operate on, while physicians could chart the progress of diseases such as multiple sclerosis or diabetic neuropathy. 'Surgeons would know where they were going in the body before they got there, and doctors would know whether or not treatment was having any effect in other diseases,' he said. Sometimes nerves are damaged during an operation.

Neurography, which is described in tomorrow's Lancet, uses existing magnetic resonance imaging systems. Although images of bone, blood vessels, the lymphatic system and the central nervous system can be obtained easily, nerves have proved resistant to imaging largely because of their size and because they are surrounded by fat and muscle.

Dr Aaron Filler, in Seattle, yesterday said: 'Currently, much of the surgical technique and operating time is concerned with locating, identifying and protecting nerves . . . where surgical treatment is being carried out. Through neurography it will be possible for a computer to obtain an exact detailed description of the course . . . of any nerve in the region of interest.'

Professor Gordon McVie, scientific director of the Cancer Research Campaign, which funded the work, said that the technique was of value to cancer surgeons. 'When a nerve runs by (or even through) a cancer, it will be possible to locate it in advance and avoid injuring it during surgery.'