Long-Term Results of Microsurgical Selective Tibial Neurotomy for Spastic Foot : Comparison of Adult and Child

Title
Long-Term Results of Microsurgical Selective Tibial Neurotomy for Spastic Foot : Comparison of Adult and Child
Author(s)
김성호김종훈이재일[이재일]김민수
Keywords
PERIPHERAL NEUROTOMY; CEREBRAL-PALSY; NERVE
Issue Date
201004
Publisher
KOREAN NEUROSURGICAL SOC
Citation
JOURNAL OF KOREAN NEUROSURGICAL SOCIETY, v.47, no.4, pp.247 - 251
Abstract
Objective : Selective neurotomy is generally a safe, effective, and long-lasting treatment for patients with spastic equinovarus foot deformity. We retrospectively analyzed the results of microsurgical selective tibial neurotomy (STN) for spastic feet in adults and children. Methods : A neurosurgeon selected 32 patients with 45 spastic feet (adults : 13, children : 32) to undergo microsurgical STN between October 1998 and September 2007. A physician of rehabilitation assessed spasticity pre- and postoperatively, that was based on the Ashworth scale, ankle clonus, and the amplitude of ankle dorsiflexion. The mean postoperative follow-up period was 36.7 months in adults and 42.5 months in children. Results : Spastic components of the feet were corrected immediately after surgery in both the adult and child groups. The mean Ashworth's grade changed from 3.6 +/- 0.40 to 1.6 +/- 0.70 in adults and from 3.7 +/- 0.69 to 1.4 +/- 0.49 in children. Mean ankle clonus decreased markedly, from 1.6 +/- 0.79 to 0.3 +/- 0.42 in adults and from 1.7 +/- 0.65 to 0.3 +/- 0.56 in children. The mean amplitude of ankle dorsiflexion was improved, but eight (adults: 4, children: 4) contracted feet needed complementary orthopedic correction for acceptable results. Conclusion : STN can be effective in the long-term for improving lower limb function and reduction of equinovarus deformity. Our results demonstrate that STN might be an effective procedure for treating localized harmful spastic feet in adults and children.
URI
http://hdl.handle.net/YU.REPOSITORY/22618http://dx.doi.org/10.3340/jkns.2010.47.4.247
ISSN
2005-3711
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의과대학 > 신경외과학교실 > Articles
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