Abstract
Phantom limb pain (PLP), neuroma-related symptoms, and the absence of authentic tactile feedback remain major limitations in amputee rehabilitation. Targeted Sensory Reinnervation (TSR) is a recently established surgical method that restores afferent somatosensory input by reinnervating defined skin territories with residual sensory nerves.
When combined with non-invasive vibrotactile feedback, TSR significantly reduces PLP, enhances embodiment, and enables physiologically meaningful sensory perception.
Beyond its role in amputees, TSR has recently been applied as part of bionic reconstruction for patients with irreversible partial brachial plexus injuries—an innovative strategy for restoring function by combining elective amputation, myoelectric prosthesis fitting, and sensory nerve rerouting.
This article provides an overview of TSR’s development, clinical evidence from lower and upper limb amputations, and its integration into bionic reconstruction protocols.
Introduction
Phantom limb syndrome and neuroma-related pain significantly restrict autonomy and quality of life in amputees. Standard treatments often provide only symptomatic relief and fail to address the fundamental problem: absence of afferent signaling from the periphery to the central nervous system. This deficit leads to maladaptive cortical reorganization and contributes to PLP and neuropathic pain.
Ten years ago, in response to patients suffering from severe drug-dependent PLP, we explored a surgical approach to close this disrupted sensory loop by restoring physiologic neural input. This concept led to the development of Targeted Sensory Reinnervation (TSR).
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