我是这样做的：选择性胫骨神经切断术。
How I do it: selective tibial neurotomy.
机构信息
Service de Neurochirurgie Fonctionnelle, Hospices Civils de Lyon, Hôpital neurologique et neurochirurgical Pierre Wertheimer, 59 Bd Pinel, 69003, Lyon, France.
Université de Lyon, Université Claude Bernard Lyon I, Lyon, France.
出版信息
Acta Neurochir (Wien). 2020 Aug;162(8):1921-1923. doi: 10.1007/s00701-020-04314-9. Epub 2020 May 7.
BACKGROUND
Selective neurotomy is known as an effective method to reduce focal spasticity when medical treatment including botulinum toxin is not sufficient. The tibial nerve can be targeted to treat spastic equinovarus foot with (or without) claw toes.
METHOD
Tibial nerve trunk is dissected in the popliteal fossa. Sensitive and motor branches are identified using electrical stimulation to monitor motor responses. The muscular nerves corresponding to the targeted muscles are partially sectioned according to a preoperative chart. A postoperative rehabilitation program is mandatory.
CONCLUSION
Precise and rigorous selective neurotomy provided a definitive and safe treatment for spastic equinovarus foot.
背景
选择性神经切断术是一种有效的方法，可在肉毒毒素等药物治疗效果不佳时，减轻局灶性痉挛。胫神经可用于治疗痉挛性马蹄内翻足（伴或不伴爪形趾）。
方法
在腘窝处解剖胫神经干。使用电刺激识别感觉和运动支，以监测运动反应。根据术前图表，部分切断对应目标肌肉的肌支。术后必须进行康复治疗。
结论
精确、严格的选择性神经切断术为痉挛性马蹄内翻足提供了一种明确且安全的治疗方法。
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