The effects of phenol neurolysis of the obturator nerve on the distribution of buttock-seat interface pressure in spinal cord injury patients with hip adductor spasticity.
OBJECTIVE
Hip adductor spasticity may adversely effect shear-force and pressure distribution on the buttocks, where ulcerations most frequently appear in patients with spinal cord injury (SCI). Phenol neurolysis of the obturator nerve (ON) is commonly used to manage hip adductor spasticity. This study aimed to determine the effects on the distribution of buttock-seat interface pressure (BSIP) in a group of SCI patients with adductor spasticity that underwent ON blockade with phenol.


METHODS
We reviewed the records of SCI patients that were admitted to our clinic between January 2009 and December 2009. BSIP values (obtained with an X-sensor 48) and hip adductor spasticity levels of SCI patients with hip adductor spasticity that underwent ON blockade with phenol were collected. BSIP distributions of the patients were divided into two portions: first one is the BSIP distribution at the pressure ≤37 mm Hg, and the second one is at the pressure >37 mm Hg.


RESULTS
The study included 20 SCI patients (19 males and 1 female), with a mean age of 42.85±13.24 years. Although the percentage of BSIP distribution at ≤37 mm Hg range increased significantly (P<0.001), after ON neurolysis, BSIP distribution at >37 mm Hg range decreased significantly (P<0.001). In addition, mean hip adductor spasticity decreased significantly after ON neurolysis (P<0.001).


CONCLUSIONS
Phenol neurolysis of the ON is a promising treatment for the management of hip adductor spasticity in SCI patients and also has positive effects on BSIP, which has a crucial function in the development of pressure ulcers.
Yaşar
E
E
Department of Physical Medicine and Rehabilitation, Gulhane Military Medical Academy, GMMA TAF Rehabilitation Center, Ankara, Turkey. evrenyasar@yahoo.com
Tok
F
F
Taşkaynatan
M A
MA
Yilmaz
B
B
Balaban
B
B
Alaca
R
R
D000328:Adult; D003714:Denervation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009128:Muscle Spasticity / Q000188:drug therapy* / Q000209:etiology* / Q000503:physiopathology; D009776:Obturator Nerve / Q000187:drug effects* / Q000503:physiopathology; D019800:Phenol / Q000494:pharmacology* / Q000627:therapeutic use; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000150:complications*; D016896:Treatment Outcome
D019800:Phenol