Published On: 01/22/2020

According to the Amputee Coalition, up to 85% of the two million amputees living in the United States suffer from chronic pain, commonly referred to as phantom limb pain or residual limb pain, and the number of amputees in the U.S. is expected to grow to 3.6 million by 2050 [1]. Recently, a surgical procedure known as Targeted Muscle Reinnervation (TMR) provides amputees with new hope for relief from pain. TMR is a novel surgical procedure first developed by Drs. Gregory A. Dumanian and Todd A. Kuiken in 2002 at Northwestern University’s Feinberg School of Medicine. TMR uses a nerve transfer, a common surgical technique, to reconnect nerves cut following amputation to nearby nerves within a muscle in the remaining limb.

“Our nervous system is like an electric grid, and severed nerves are like live wires that cause pain,” Dr. Dumanian said. “In TMR the amputated nerve, the ‘live wire’, is surgically rerouted to reinnervate a nearby functionless muscle, thereby closing the circuit. Simply put, TMR gives the nerve somewhere to go and something to do, a strategy absent from all other neuroma treatments,” he said.

Dr. Dumanian and his peers recently published the results of a clinical trial for the treatment of postamputation pain in major limb amputees in the Annals of Surgery [2]. The study found TMR resulted in a significantly greater reduction in phantom limb pain and a trend toward improved residual limb pain compared to standard treatment. Speaking in reference to the study patients, Dr. Dumanian observed, “This study proves what we’ve seen anecdotally, that TMR is the first major advance in the way we treat residual and phantom limb pain since the onset of amputations thousands of years ago. Respite from pain means freedom from narcotics, freedom to engage in physical activity, freedom to enjoy time with family and friends, freedom to pursue careers and much more.”

In another study recently published in the Journal of Surgical Oncology [3] by Dr. Ian Valerio of The Ohio State University (now of Massachusetts General Hospital) and his peers, amputees receiving TMR reduced their dependence on narcotic pain medication from 56% who were treated with opioids before TMR compared to 22% one year following the procedure. “We’re actually impacting the opioid crisis and getting patients off opioids,” said Dr. Valerio commenting on the results of this study.

According to many TMR surgeons, Checkpoint’s nerve stimulation technology plays an important role in the procedure. “Checkpoint’s device makes the most technically challenging aspect of the procedure, targeting recipient nerves, easy to do making the procedure easily transferable to any micro-vascular trained surgeon interested in offering the procedure,” said Dr. Valerio. “Based on my experience, TMR is very difficult to perform without Checkpoint’s stimulator,” said Stephen J. Kovach, MD, from Penn Medicine.

“We’re extremely gratified that our technology helps facilitate this ground-breaking TMR procedure that promises to bring relief and restore quality of life to many amputees experiencing phantom limb or residual limb pain,” said Len Cosentino, CEO of Checkpoint Surgical. “We’re also encouraged that TMR may help these patients reduce or dispense with the need for opioids to address their pain. This is core to our mission as an enterprise.”

Checkpoint Surgical (Cleveland, Ohio) is a privately held medical device company committed to providing surgeons with user-friendly, cost-effective devices to protect and repair nerves intraoperatively across the anatomy. Our mission is to advance the science and practice of nerve protection and repair to improve the quality of life for patients and physicians. Our technologies are state of the art for hand-held motor nerve location, identification and assessment in peripheral nerve repair surgery, targeted muscle reinnervation, upper and lower extremity orthopedic surgery, and head and neck surgical oncology. For more information regarding Checkpoint Surgical please visit www.checkpointsurgical.com.

Checkpoint Surgical’s flagship product, the Checkpoint® Stimulator/Locator is a state of the art handheld, single use, intraoperative nerve and muscle stimulator that helps surgeons locate, identify and evaluate motor nerve tissue and muscle function in complex surgical procedures that require careful tissue dissection or nerve exploration and repair. The Checkpoint® Head & Neck is a hand-held, single use, intraoperative nerve stimulator designed specifically for head & neck procedures to help surgeons locate, identify and evaluate motor nerve tissue and muscle function in surgical procedures that require reliable nerve assessment, protection and repair.