Neurolytic phenol blockade of the obturator nerve for severe adductor spasticity.
BACKGROUND
In this study, we present the 3-month follow-up results of a retrospective analysis of obturator nerve (ON) phenol neurolysis performed between 2000 and 2007 in patients with adductor spasticity.


METHODS
The study was performed by retrospective investigation of the clinical follow-up results of 80 ON phenol treatments in 62 patients. Neurolysis using 5-10 ml 6% phenol was applied with the guidance of fluoroscopy and a peripheral nerve stimulator. Pain, spasticity and hygiene were evaluated and the hip abduction range of motion (ROM) was measured at the end of the first week and in the first, second and third months following the intervention.


RESULTS
The visual analogue scale scores decreased significantly in the first week, first month and the second month, but reached their initial values in the third month. A drastic increase in the ROM values was shown in hip abduction in the first week, first month and second month. An increase in the Ashworth Scale values was observed in the second and third months, but they did not reach their initial values. The hygiene score decreased drastically in the first week and the first and second months, but worsened in the third month. The success rate in nerve localization during ON neurolysis was 100%.


CONCLUSIONS
ON phenol blockade with fluoroscopy and peripheral nerve stimulator guidance in patients with adductor spasticity led to a decrease in spasticity and pain with an increase in the ROM of the hip and better hygiene with an efficacy lasting for about 3 months.
Ministry of Health Diskapi Yildirim Beyazit Research and Educational Hospital, Clinic of I. Anaesthesiology-Reanimation & Pain Unit, Ankara, Turkey. taylanakkaya@yahoo.com
T
T
Akkaya
E
E
Unlu
A
A
Alptekin
H I
HI
Gumus
E
E
Umay
A
A
Cakci
D000328:Adult; D005260:Female; D006621:Hip Joint; D006801:Humans; D008297:Male; D009128:Muscle Spasticity / Q000188:drug therapy*; D009407:Nerve Block / Q000379:methods*; D009776:Obturator Nerve / Q000187:drug effects*; D010147:Pain Measurement; D019800:Phenol / Q000008:administration & dosage*; D016059:Range of Motion, Articular / Q000187:drug effects; D012189:Retrospective Studies; D012597:Sclerosing Solutions / Q000008:administration & dosage*; D013997:Time Factors; D016896:Treatment Outcome
D012597:Sclerosing Solutions; D019800:Phenol