Every surgery carries nerve injury risk specific to the anatomy involved. The nerves at risk during thyroid surgery are completely different from those threatened during knee replacement. Understanding where nerves are vulnerable in your type of surgery—and what surgeons should do to protect them—helps evaluate whether your injury represents an acceptable complication or preventable negligence.
Thyroid and Neck Surgery
The recurrent laryngeal nerve controls your vocal cords, and it runs dangerously close to the thyroid gland. This proximity is why voice changes are a known risk of thyroid surgery—and why careful surgeons take specific precautions to avoid damaging this critical structure.
Proper technique involves identifying and visualizing the nerve before removing thyroid tissue, often with the assistance of nerve monitoring equipment that alerts the surgeon when instruments approach too closely. When surgeons take these precautions, permanent voice damage is rare. When they don't—when they operate aggressively without locating the nerve, when they ignore monitoring alerts, when they proceed despite anatomical variations that increase risk—patients end up with voices permanently changed or lost entirely.
Bilateral nerve damage—affecting both vocal cords—can require permanent tracheostomy because the paralyzed cords obstruct the airway. This catastrophic outcome is vanishingly rare with competent technique, and its occurrence strongly suggests negligence.
Hernia Repair
The groin contains several nerves that can be injured during inguinal hernia repair: the ilioinguinal, iliohypogastric, and genitofemoral nerves. Damage to these structures causes chronic groin pain that persists long after the surgical site has healed—pain with movement, pain with touch, pain that interferes with work and daily activities and intimacy.
Post-herniorrhaphy pain syndrome affects roughly 10% of hernia surgery patients to some degree. In many cases, it results from identifiable nerve injury during the procedure—nerves that were cut, sutured into mesh, or trapped in scar tissue because the surgeon didn't take care to identify and protect them. When surgeons fail to locate nerves that standard anatomical knowledge tells them are present, or when they place sutures or mesh without regard for nearby neural structures, the resulting chronic pain is their responsibility.
Hip and Knee Replacement
Joint replacement surgery threatens the major nerves of the lower extremity. Hip replacement puts the sciatic and femoral nerves at risk. Damage to the sciatic nerve causes foot drop—inability to lift the front of the foot—along with weakness and numbness extending down the leg. Femoral nerve damage affects thigh sensation and the ability to extend the knee, making walking difficult or impossible without assistance.
Knee replacement particularly threatens the peroneal nerve, which wraps around the head of the fibula near the surgical field. Peroneal nerve damage causes the classic foot drop that requires a brace for walking and may never fully recover.
These injuries result from excessive retraction that stretches nerves beyond their tolerance, direct trauma from instruments, improper patient positioning during surgery, or post-operative hematomas that compress nerves before anyone recognizes the problem. Each of these causes represents a failure to meet the standard of care.
Spine Surgery
Operating near the spinal cord and nerve roots carries inherent risk, but that risk doesn't excuse negligence. Surgeons who operate at the wrong spinal level—taking out the wrong disc, fusing the wrong vertebrae—have made an error that should never happen with proper imaging and verification. Surgeons who place hardware improperly, compressing nerve roots with screws or rods, have failed to meet basic technical standards. Surgeons who use excessive force or inadequate visualization and damage structures they should have protected can't hide behind the general riskiness of spine surgery.
Spinal nerve injuries cause devastating consequences: permanent weakness or paralysis, loss of sensation across entire regions of the body, bowel and bladder dysfunction that requires catheters and specialized care, chronic pain that doesn't respond to treatment. When these outcomes result from negligence rather than irreducible surgical risk, they warrant substantial compensation.
Pelvic Surgery
Hysterectomy, prostatectomy, and colorectal surgery all navigate the complex nerve networks of the pelvis. The pudendal nerve controls sensation and continence; damage causes numbness, urinary or fecal incontinence, and sexual dysfunction. The pelvic autonomic nerves, particularly important in prostatectomy, control erectile function—even "nerve-sparing" procedures can damage them when performed without adequate skill or care. The obturator nerve affects thigh movement and can be injured during pelvic lymph node dissection.
These are life-altering injuries. Incontinence requires pads or diapers, affects every aspect of daily life, and often leads to social isolation and depression. Erectile dysfunction after prostatectomy devastates men who were told nerve-sparing surgery would preserve function. When these outcomes result from surgical technique that fell below professional standards, patients deserve compensation for what was taken from them.
When Nerve Injury Is Malpractice
The question in every case is whether the surgeon took reasonable precautions given the known risks. Did they identify nerves in the surgical field before cutting? Did they use available monitoring technology? Did they adjust technique when anatomical variations increased risk? Did they recognize and respond appropriately to intraoperative signs of nerve injury? The answers to these questions determine whether your injury was an accepted risk of surgery or the result of negligence that could have been avoided.