Does fascicular neurotomy have long-lasting effects?
OBJECTIVE
To determine whether fascicular neurotomy has long-lasting effects on spasticity.


METHODS
We present 4 clinical cases and a critical analysis of the literature.


METHODS
This is a retrospective study on 4 patients referred to our department for spastic equinovarus foot deformity. For all 4, neurotomy was successful not long after surgery, but spasticity reappeared after a few months.


METHODS
We compared our results with those in the PubMed database.


RESULTS
Most publications acknowledge the immediate effectiveness of this surgery, but do not study the long-term effects of neurotomy. No publication proved long-lasting effects of neurotomy for spastic equinovarus foot deformity. The only long-term follow-up with a sufficient population is the one of Berard et al. who reported 61% recurrence.


CONCLUSIONS
There is no study showing that tibial nerve neurotomy has long-lasting effects. The 4 cases reported are an illustration that recurrence of spasticity may occur after neurotomy. These findings have to be taken into account for treatment decision-making and for provision of information to patients.
Collado
Hervé
H
Department of Physical and Rehabilitation Medicine, Faculté de Médecine, Université de la Méditerranée, Assistance Publique Hopitaux de Marseille, University Hospital La Timone, Marseille, France. hervecollado@neuf.fr
Bensoussan
Laurent
L
Viton
Jean-Michel
JM
Milhe De Bovis
Virginie
V
Delarque
Alain
A
D000328:Adult; D001930:Brain Injuries / Q000150:complications / Q000503:physiopathology / Q000534:rehabilitation; D002648:Child; D004863:Equinus Deformity / Q000209:etiology / Q000534:rehabilitation / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009128:Muscle Spasticity / Q000209:etiology / Q000534:rehabilitation / Q000601:surgery; D020127:Recovery of Function; D012008:Recurrence; D012189:Retrospective Studies; D020521:Stroke / Q000150:complications / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D013979:Tibial Nerve / Q000601:surgery*; D016896:Treatment Outcome; D016138:Walking