Highly selective peripheral neurotomy as a treatment of cerebral palsy spasm

Objective In the patients with spastic cerebral palsy, deformities such as club foot, inversion foot and scissor gait often arise form the imbalance in the adductors muscle group of the thigh and leg and their antagonistic muscle groups. The incerased muscular tension of the former constitutes the rationale of neurotomy. Methods Highly selective peripheral neurotomy in 38 children who suffered from lower limb deformity secondary to unequal nuscular tension. Twenty-one of the children underwent obturator neurotomy, 27 sciatic neurotomy, and 26 tibial neurotomy. Using electric stimulation, the fasciculi involved were decided and severed. The proportion of fasciculi severed depended on the degree of the muscular tension. Results All patients function improved postoperatiely. 80 % of the patients experienced significant improvement. Conclusion Selective peripheral neurotomy is not only more effective and it also has less complication than selective posterior rhizotomy (SPR) in treating cerebral palsy spasm.

Objective In the patients with spastic cerebral palsy, deformities such as club foot, inversion foot and scissor gait often arise form the imbalance in the adductors muscle group of the thigh and leg and their antagonistic muscle groups. The incerased muscular tension of the former constitutes the rationale of neurotomy. Methods Highly selective peripheral neurotomy in 38 children who suffered from lower limb deformity secondary to unequal nuscular tension. Twenty-one of the children underwent obturator neurotomy, 27 sciatic neurotomy, and 26 tibial neurotomy. Using electric stimulation, the fasciculi involved were decided and severed. The proportion of fasciculi severed depended on the degree of the muscular tension. Results All patients function improved postoperatiely. 80 % of the patients experienced significant improvement. Conclusion Selective peripheral neurotomy is not only more effective and it also has less complication than selective posterior rhizotomy (SPR) in treating cerebral palsy spasm. 5 refs.