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Updated: Dec 22, 2025

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How I do it: selective tibial neurotomy.

Corentin Dauleac1,2, Marc Sindou3, Patrick Mertens4,5,6

  • 1Service de Neurochirurgie Fonctionnelle, Hospices Civils de Lyon, Hôpital neurologique et neurochirurgical Pierre Wertheimer, 59 Bd Pinel, 69003, Lyon, France. corentin.dauleac@chu-lyon.fr.

Acta Neurochirurgica
|May 8, 2020
PubMed
Summary

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Selective neurotomy offers a definitive and safe treatment for focal spasticity, particularly for spastic equinovarus foot, when other medical treatments are insufficient. This procedure precisely targets the tibial nerve and its branches.

Area of Science:

  • Neurosurgery
  • Orthopedic Surgery
  • Neurology

Background:

  • Selective neurotomy is an effective treatment for focal spasticity.
  • It is considered when medical interventions like botulinum toxin are insufficient.
  • The tibial nerve is a target for treating spastic equinovarus foot, with or without claw toes.

Purpose of the Study:

  • To evaluate the efficacy and safety of selective neurotomy for spastic equinovarus foot.
  • To provide a definitive treatment option for focal spasticity unresponsive to other therapies.

Main Methods:

  • The tibial nerve trunk is dissected in the popliteal fossa.
  • Electrical stimulation is used to identify sensitive and motor branches.
  • Muscular nerves are partially sectioned based on a preoperative chart, followed by a mandatory rehabilitation program.
Keywords:
MicrosurgerySelective neurotomySpastic footSpasticityTibial nerve

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Main Results:

  • Selective neurotomy provides precise targeting of nerve branches.
  • The procedure effectively reduces spasticity in the targeted foot muscles.
  • Postoperative rehabilitation is crucial for optimal outcomes.

Conclusions:

  • Selective neurotomy is a definitive and safe treatment for spastic equinovarus foot.
  • Rigorous technique ensures successful outcomes in managing focal spasticity.
  • This surgical approach offers a valuable alternative for patients with refractory spasticity.