Targeted Muscle Reinnervation in the Oncologic Population: A Literature Review and Current Practice

The goal of this review is to discuss the surgical technique of Targeted Muscle Reinnervation (TMR) in the oncologic population. The technique not only improves myoelectric prosthetic control, but is a method to relieve post-amputation chronic residual and phantom limb pain. TMR is a surgical procedure that effectively amplifies neural control signals on surface musculature. Fortuitously, TMR has also been shown to also reduce chronic residual and phantom limb pain when performed in a delayed or immediate manner. While most data exists in traumatic or orthopedic amputees, TMR is an emerging technique in the oncologic population. Although important for prosthetic control, it is arguably most beneficial for the oncologic population due to the ability to reduce pain without opioids. TMR improves myoelectric prosthesis control and early results demonstrate marked improvement in post-amputation chronic pain and quality of life within the oncologic population.