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Child's Nervous System

Published in:

01-09-2007 | Special Annual Issue

Selective peripheral neurotomy (SPN) for spasticity in childhood

Authors: M. P. Sindou, F. Simon, P. Mertens, P. Decq

Published in: Child's Nervous System | Issue 9/2007

Abstract

Overview

Excess spasticity leads to disability that is marked by impaired locomotion, handicapping deformities and, if not controlled, discomfort and pain. Selective peripheral neurotomy in the child is indicated for severe focal spasticity, when botulinum toxin injections cannot delay surgery any longer.

Materials and methods

Preoperative motor blocks mimicking the outcome of the surgical procedure are essential to establish the objectives of neurotomy. In the lower limb, obturator neurotomy is indicated for spasticity in the adductor muscles, hamstring neurotomy for the knee flexion and tibial neurotomy for the spastic foot. Anterior tibial neurotomy is indicated for the extensor hallucis spasticity and femoral neurotomy for spasticity in the quadriceps. In the upper limb, neurotomy of the pectoralis major and teres major nerves is indicated for spasticity of the internal rotators of the shoulder. Neurotomy of the musculocutaneous nerve is indicated for spasticity of the flexors of the elbow, and neurotomy of median and ulnar nerves are indicated for spasticity of the pronators and flexors of the wrist and fingers.

Conclusion

Selective peripheral neurotomy is a valuable neurosurgical procedure in well-trained surgical hands for severe focalised spasticity.

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Title: Selective peripheral neurotomy (SPN) for spasticity in childhood
Authors: M. P. Sindou
F. Simon
P. Mertens
P. Decq
Publication date: 01-09-2007
Publisher: Springer-Verlag
Published in: Child's Nervous System / Issue 9/2007
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI: https://doi.org/10.1007/s00381-007-0399-1

At a glance: The STEP trials

Springer Medicine

Selective peripheral neurotomy (SPN) for spasticity in childhood

Abstract

Overview

Materials and methods

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Overview

Materials and methods

Conclusion

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