Mr Marco Sinisi

Mr Marco Sinisi Peripheral Nerve Surgeon and Nerve Repair

Mr Marco Sinisi is a consultant neurosurgeon whose clinical work focuses on peripheral nerve injuries, brachial plexus disorders, nerve compression, nerve tumours, and reconstructive treatment following paralysis. He treats nerve conditions that may affect movement, strength, sensation, comfort, and a patient’s ability to complete everyday tasks. Peripheral nerves carry signals between the brain, spinal cord, muscles, skin, and other parts of the body. When a nerve is compressed, stretched, divided, or otherwise damaged, patients may experience pain, tingling, numbness, muscle weakness, reduced coordination, or loss of movement. Mr Sinisi’s role is to identify the affected nerve, assess its potential for recovery, and determine whether observation, rehabilitation, surgery, or combined care may be appropriate.

About Mr Marco Sinisi

Mr Sinisi trained in neurosurgery before directing his practice towards complex peripheral nerve conditions. His documented clinical interests include adult and obstetric brachial plexus injuries, traumatic nerve damage, peripheral nerve tumours, and reconstructive procedures for patients affected by paralysis. His work may be relevant for patients whose nerve symptoms developed after an accident, fracture, dislocation, sports injury, birth injury, previous operation, long-term compression, or tumour. Some patients seek assessment soon after an injury, while others need a second opinion because strength, movement, or sensation has not returned as expected. Mr Sinisi’s practice forms part of specialised surgical care, where treatment decisions depend on the nerve involved, the cause and severity of the damage, the patient’s general health, and the time that has passed since symptoms began.

Professional Background and Experience

Mr Sinisi graduated in medicine from the University of Milan in 1997 and completed specialist neurosurgical training at the Institute of Neurosurgery of Milan. He later worked at the Carlo Besta Neurological Institute, where he was involved in developing surgical treatment for peripheral nerve disorders. In 2004, he joined the Peripheral Nerve Injury Unit at the Royal National Orthopaedic Hospital as a consultant. His professional work combines patient care, complex surgical planning, medical education, and research related to peripheral nerve injuries. He also holds an honorary academic appointment at University College London and has contributed to numerous scientific papers and professional presentations.

Education and Specialist Training

Training Area	Institution	Details
Medical education	University of Milan	Medical degree completed in 1997
Specialist training	Institute of Neurosurgery of Milan	Neurosurgical training
Early consultant work	Carlo Besta Neurological Institute	Surgical care for peripheral nerve disorders
Specialist appointment	Royal National Orthopaedic Hospital	Peripheral Nerve Injury Unit
Academic work	University College London	Honorary academic appointment

Neurosurgical training provides detailed knowledge of the brain, spinal cord, nerve roots, and peripheral nervous system. Mr Sinisi later developed a focused practice in peripheral nerve surgery, where treatment may involve microsurgical techniques, nerve reconstruction, tendon transfers, and coordinated rehabilitation.

Main Areas of Peripheral Nerve Care

Traumatic Peripheral Nerve Injuries

A peripheral nerve may be damaged by a cut, crush injury, fracture, dislocation, stretching force, or severe impact. Nerve damage can also occur during an operation or when scar tissue develops around a nerve. The effect of an injury depends on whether the nerve has been bruised, compressed, stretched, partly divided, or completely severed. A mild nerve injury may recover naturally, while a more serious injury may require surgical exploration, repair, grafting, or nerve transfer. Possible symptoms include:

• Loss of normal feeling
• Tingling or burning sensations
• Muscle weakness
• Reduced grip strength
• Difficulty lifting an arm or foot
• Loss of movement in part of a limb
• Pain following an accident
• Muscle wasting
• Reduced coordination
• Increased sensitivity around the injured area

Patients can read more about peripheral neuropathy symptoms to understand how damaged peripheral nerves may affect sensation and movement. Symptoms vary widely, so a clinical assessment is needed to identify the actual cause.

Brachial Plexus Injuries

The brachial plexus is a network of nerves that begins near the neck and controls much of the movement and sensation in the shoulder, arm, forearm, and hand. A brachial plexus injury may occur when these nerves are stretched, compressed, or torn. Causes can include road accidents, falls, contact sports, tumours, inflammation, or injuries during birth. The severity may range from temporary weakness in a small group of muscles to extensive loss of movement and feeling throughout an arm. Patients may notice:

• Shoulder weakness
• Difficulty bending the elbow
• Loss of wrist or hand movement
• Numbness in part of the arm
• Burning or electric-like pain
• Reduced grip
• Muscle wasting
• A heavy or unsupported feeling in the arm

Mr Sinisi’s documented interests include adult and obstetric brachial plexus lesions and reconstructive work for patients affected by paralysis.

Obstetric Brachial Plexus Injury

An obstetric brachial plexus injury develops around the time of birth and may affect movement in a baby’s shoulder, arm, or hand. Erb’s palsy is one recognised pattern of this type of nerve injury. Some children show gradual improvement as the affected nerves recover. Others may require specialist monitoring, physiotherapy, imaging, electrical testing, or surgery. Assessment may consider:

• Which arm movements are present
• Whether strength is improving
• The specific muscles affected
• The pattern of nerve involvement
• Joint flexibility
• Shoulder position
• Muscle tightness
• Progress during therapy

Parents can also read about birth trauma and conditions such as Erb’s palsy before discussing their child’s individual needs with an appropriate specialist.

Entrapment Neuropathy

Entrapment neuropathy occurs when a nerve is compressed within a narrow passage or by surrounding tissue. The pressure may initially cause occasional tingling but can eventually lead to persistent numbness, weakness, reduced coordination, or muscle loss. Examples include carpal tunnel syndrome at the wrist and cubital tunnel syndrome around the elbow. Possible symptoms include:

• Numbness in particular fingers
• Tingling that becomes worse at night
• Hand weakness
• Reduced grip strength
• Difficulty handling small objects
• Pain around the wrist or elbow
• Symptoms linked to certain arm positions
• Dropping objects more frequently

Not every compressed nerve requires surgery. Treatment may begin with activity changes, splinting, therapy, medication, or management of an underlying condition. Patients can review reliable information about carpal tunnel syndrome, including common symptoms, diagnostic testing, and treatment approaches.

Peripheral Nerve Tumours

Peripheral nerve tumours form within or near the protective tissues surrounding a nerve. Many nerve sheath tumours are non-cancerous, but any unexplained lump, increasing pain, weakness, or change in sensation requires proper assessment. A tumour may cause:

• A noticeable lump
• Localised pain
• Pain travelling along a nerve
• Tingling or numbness
• Muscle weakness
• Loss of function
• Increasing symptoms as the growth becomes larger

Assessment may involve MRI, ultrasound, electrical nerve studies, and sometimes a biopsy. Surgical planning must balance removal of the tumour with protection of functioning nerve fibres. The National Cancer Institute provides information about malignant peripheral nerve sheath tumours, which are rare cancers arising from the tissues covering peripheral nerves. Most nerve-related symptoms are not evidence of cancer, but unexplained or progressive problems should be medically evaluated.

Reconstructive Care After Paralysis

A serious nerve injury may leave a muscle without a working nerve supply. When natural nerve recovery is unlikely to restore useful movement, reconstructive procedures may be considered. Treatment may aim to improve:

• Shoulder stability
• Elbow bending
• Wrist position
• Hand opening or closing
• Grip strength
• Finger movement
• Foot or ankle control
• Independence with everyday activities

It may not be possible to restore every lost movement. Treatment is often planned around the functions that would provide the greatest practical benefit to the patient.

Conditions Mr Sinisi May Evaluate

Mr Sinisi’s documented areas of specialist care include:

• Peripheral nerve injuries
• Adult brachial plexus injuries
• Obstetric brachial plexus injuries
• Erb’s palsy
• Traumatic nerve lesions
• Entrapment neuropathies
• Carpal tunnel syndrome
• Cubital tunnel syndrome
• Peripheral nerve tumours
• Pain caused by nerve trauma
• Muscle weakness linked to nerve damage
• Paralysis affecting an arm or limb
• Loss of function after an accident
• Persistent symptoms following nerve surgery
• Complex nerve injuries requiring reconstruction

An appointment does not automatically mean an operation will be recommended. The first step is to determine whether the symptoms arise from a peripheral nerve, nerve root, spinal cord condition, muscle disorder, joint problem, or another cause.

Procedures Connected With His Practice

Mr Sinisi’s listed procedures include nerve repair, nerve decompression, peripheral nerve surgery, carpal tunnel decompression, cubital tunnel release, tendon transfer surgery, and reconstructive treatment after paralysis.

Nerve Decompression

Nerve decompression involves releasing tissue that is placing pressure on a nerve. It may be considered when symptoms continue despite suitable nonsurgical care, electrical tests show significant nerve compression, or muscle weakness is becoming more noticeable. The goal is to reduce pressure and create enough space for the nerve to function and recover.

Neurolysis

Neurolysis involves carefully freeing a nerve from scar tissue or surrounding structures that restrict its movement. This procedure may be considered following trauma or previous surgery when scar tissue has formed around the nerve. The surgeon must determine whether releasing the nerve is likely to improve symptoms or function.

Direct Nerve Repair

When a nerve has been cleanly divided, it may sometimes be repaired by bringing the healthy ends together. Direct repair is more likely to be possible when the gap is small and the nerve ends can be joined without excessive tension.

Nerve Grafting

A nerve graft may be required when damaged tissue creates a gap between the healthy nerve ends. A section of another suitable nerve is used to create a pathway across the injured area. New nerve fibres then need to grow through the graft towards the affected muscles or skin.

Nerve Transfer Surgery

A nerve transfer connects a functioning nerve, or part of one, to a damaged nerve pathway. This approach may reduce the distance new nerve fibres must travel before reaching an important muscle. It can be considered in selected brachial plexus and severe peripheral nerve injuries.

Tendon or Muscle Transfer

When nerve recovery is unlikely to restore a useful movement, a functioning tendon or muscle may be redirected to perform a different action. This type of reconstruction is planned around the movements the patient still has and the functions they most need to regain.

How Peripheral Nerve Conditions Are Assessed

A specialist assessment usually combines the patient’s history, physical examination, previous treatment records, imaging, and nerve tests. The consultation may examine:

• How and when the injury occurred
• Which movements were lost
• Whether function has changed over time
• The pattern of pain or numbness
• Individual muscle strength
• Reflexes
• Joint movement
• Muscle wasting
• Skin sensitivity
• Previous surgical scars
• The effect on work, school, sleep, and daily activities

Tests may include:

• MRI
• Ultrasound
• Electromyography
• Nerve conduction studies
• X-rays after fractures or dislocations
• CT imaging in selected cases
• Repeat examinations to monitor recovery

Imaging and electrical tests provide different information. A scan can show the structures surrounding a nerve, while nerve conduction studies and electromyography examine how signals travel through nerves and muscles.

Who May Benefit From Seeing Mr Sinisi

A specialist consultation may be useful for patients who:

• Have lost movement following an injury
• Have persistent numbness or weakness
• Experience severe pain along a nerve
• Have a suspected brachial plexus injury
• Have a child with a birth-related nerve injury
• Have been diagnosed with a peripheral nerve tumour
• Have symptoms that continued after decompression surgery
• Need an opinion about nerve grafting or nerve transfer
• Want a second opinion before reconstructive surgery
• Have unexplained weakness following trauma
• Need coordinated surgical and rehabilitation care
• Have been told that nerve recovery is uncertain

Patients can use the Doctiplus doctor and specialist directory when comparing suitable healthcare professionals or seeking an additional opinion.

What Patients Can Expect During an Appointment

The first consultation usually focuses on understanding how the condition began, what functions have been affected, and whether symptoms are improving. Patients may be asked:

• When did the problem begin?
• Was there an accident, operation, or birth injury?
• Which movements are difficult or impossible?
• Has strength improved since the injury?
• Is there pain, numbness, or tingling?
• Have previous operations been performed?
• Has physiotherapy helped?
• Which tests have already been completed?
• How does the condition affect daily life?
• Which result matters most to the patient?

A physical examination may test individual muscles rather than only checking general arm or leg strength. This can help identify which nerve pathways remain active and which appear damaged. The treatment plan may involve continued observation, further tests, physiotherapy, pain care, surgery, or referral to another professional.

Preparing for the Consultation

Patients can prepare by bringing:

• A current medication list
• Details of the original injury
• Accident or operation reports
• Previous clinic letters
• MRI or CT images
• Ultrasound reports
• Electromyography results
• Nerve conduction study reports
• Previous surgical notes
• Physiotherapy records
• A timeline of changes in movement
• Videos showing earlier or changing function
• A list of questions
• Insurance or referral documents

For a recent injury, it is useful to record which movements were possible immediately afterwards and whether any strength has returned. For a longer-term condition, patients should explain which daily activities remain difficult. Examples may include dressing, holding cutlery, writing, walking, using stairs, driving, or returning to work.

Questions to Ask During the Consultation

Patients may consider asking:

• Which nerve or part of the brachial plexus is affected?
• Is the nerve likely to recover without surgery?
• How long should recovery be observed?
• Are more scans or electrical tests required?
• What type of operation may be considered?
• What movement could the procedure realistically restore?
• Are nerve grafting or nerve transfer suitable?
• What may happen if surgery is delayed?
• Could tendon or muscle transfer be needed?
• How long may nerve recovery take?
• What rehabilitation will be required?
• Could more than one procedure be necessary?
• What are the main surgical risks?
• How will progress be measured?
• Would another specialist opinion be helpful?

Clear expectations are important because peripheral nerve recovery is often gradual. The final result may take months to become apparent and can vary between patients.

Recovery and Rehabilitation

Peripheral nerves generally recover more slowly than skin or bone. A repaired nerve may need to grow a considerable distance before reaching the muscle or area of skin it supplies. Recovery may involve:

• Wound care
• Temporary protection of the repaired area
• Pain management
• Splinting
• Physiotherapy
• Occupational therapy
• Strengthening exercises
• Sensory retraining
• Prevention of joint stiffness
• Repeat nerve testing
• Monitoring for returning movement
• Adaptations for work or daily activities

Patients should follow the plan provided by their surgical and rehabilitation teams. Excessive activity too early may place stress on healing tissues, while prolonged inactivity may increase stiffness and muscle loss. General NHS guidance explains that treatment for peripheral neuropathy depends on its underlying cause and may include symptom management, rehabilitation, or care for nerve pain.

Practice and Appointment Information

Mr Sinisi is associated with the Peripheral Nerve Injury Unit at the Royal National Orthopaedic Hospital. His private appointments are also connected with The Wellington Hospital and The Portland Hospital. He provides care for peripheral nerve conditions affecting adults, while some paediatric consultations and procedures may be arranged through specialist children’s services. English and Italian are listed among the languages he speaks. Appointment availability, clinic location, referral requirements, insurance participation, and treatment facilities may change. Patients should confirm current information directly with the relevant hospital or clinic before booking.

Insurance and Referral Preparation

Before arranging a consultation, patients may wish to ask:

• Is a referral letter required?
• Should medical records be reviewed before booking?
• Does the clinic need imaging in advance?
• Is the consultation covered by insurance?
• Does the insurer require prior authorisation?
• Are diagnostic tests charged separately?
• Which hospital would provide treatment?
• Will rehabilitation be arranged through the same team?
• Is an initial remote consultation available?
• Are international referrals accepted?

Insurance approval for a consultation may not automatically include diagnostic tests, hospital fees, surgery, or rehabilitation. Each part of the proposed care should be confirmed separately.

When Symptoms Need Urgent Medical Care

A routine specialist appointment is not suitable for an immediate emergency. Urgent assessment may be needed for:

• Sudden loss of movement after a serious injury
• Severe bleeding or an open wound
• A cold, pale, blue, or severely swollen limb
• Rapidly increasing weakness
• Severe pain following a fracture or dislocation
• Loss of sensation after major trauma
• Signs of infection after surgery
• Breathing difficulty following a neck or shoulder injury
• New weakness affecting several limbs
• Sudden bladder or bowel problems with neurological symptoms

Patients should contact emergency services or attend an emergency department when symptoms are sudden, severe, or rapidly worsening.

Profile Accuracy

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