Femoral obturator and sciatic neurectomy with iliacus and psoas muscle section for spasticity following spinal cord injury.
The treatment of severe refractory spasticity following spinal cord injury may raise challenging therapeutic problems. Classical approaches involve various types of myelotomies, rhizotomies and intrathecal injections of neurolytic substances. Alternative approaches include percutaneous rhizotomies and, more recently, the possible use of electrical stimulation of the spinal cord. Certain cases, however, may not be amenable to commonly accepted techniques. An operative technique is presented which involves a suprapubic incision for an infraperitoneal approach to a femoral and obturator neurectomy and an incision of the iliacus and psoas muscles bilaterally. This may be followed, when indicated, by a bilateral infragluteal section of the sciatic nerves. This technique offers a viable surgical alternative to the treatment of spasticity following spinal cord injury in cases where other traditional methods are contraindicated or have failed.
Benzel
E C
EC
Division of Neurosurgery, LSU Medical Center, Shreveport.
Barolat-Romana
G
G
Larson
S J
SJ
D000293:Adolescent; D005267:Femoral Nerve / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009128:Muscle Spasticity / Q000209:etiology / Q000601:surgery*; D009132:Muscles / Q000601:surgery*; D009776:Obturator Nerve / Q000601:surgery*; D012584:Sciatic Nerve / Q000601:surgery*; D013119:Spinal Cord Injuries / Q000150:complications*