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Does fascicular neurotomy have long lasting effects ?
COLLADO H; BENSOUSSAN L; VITON JM; MILHE DE BOVIS V; DELARQUE A
J REHABIL MED , 2006, vol. 38, n° 4, p. 212-217 Doc n°: 125409 Localisation : Documentation IRR Descripteurs : AD32 - SPASTICITE, DE851 - ANOMALIES MORPHOLOGIQUES / PIED OBJECTIVE: To determine whether fascicular neurotomy has long-lasting effects on spasticity. DESIGN: We present 4 clinical cases and a critical analysis of the literature. PATIENTS: This is a retrospective study on 4 patients referred to our department for spastic equinovarus foot deformity. For all 4, neurotomy was successful not long after surgery, but spasticity reappeared after a few months. METHODS: We compared our results with those in the PubMed database. RESULTS: Most publications acknowledge the immediate effectiveness of this surgery, but do not study the long-term effects of neurotomy. No publication proved long-lasting effects of neurotomy for spastic equinovarus foot deformity. The only long-term follow-up with a sufficient population is the one of Berard et al. who reported 61% recurrence. CONCLUSION: There is no study showing that tibial nerve neurotomy has long-lasting effects. The 4 cases reported are an illustration that recurrence of spasticity may occur after neurotomy. These findings have to be taken into account for treatment decision-making and for provision of information to patients. Langue : ANGLAIS |
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