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Hyper-selective neurectomy for knee flexion spasticity: anatomic bases and surgical technique
Mohammadreza Emamhadi1,2, Babak Alijani3, Mohammad Haghani Dogahe4
1Department of Neurosurgery, Guilan University of Medical Sciences, Rasht, Iran. emamhadi42@yahoo.com.
Surgical and Radiologic Anatomy : SRA
|January 12, 2023
Summary
Hyper-selective neurectomy (HSN) effectively treats lower limb spasticity after brain injury. This advanced surgical technique offers a safe and reliable solution for patients experiencing persistent muscle stiffness.
Area of Science:
- Neurosurgery
- Neurology
- Orthopedic Surgery
Background:
- Spasticity, often resulting from corticospinal tract damage post-head trauma, traditionally involves limited peripheral nerve surgeries like selective neurectomies.
- Lower limb spasticity significantly impacts mobility and quality of life.
Observation:
- This study details the anatomical basis and surgical technique of hyper-selective neurectomy (HSN) for hamstring spasticity.
- A case report of a 23-year-old male with severe spastic knee flexion following brain injury is presented.
Findings:
- HSN involved precise resection of specific nerve rami at the muscle entry point.
- Post-surgery, Visual Analog Scale and Modified Ashworth scores improved, indicating reduced spasticity.
- Popliteal angle significantly improved, enhancing knee extension.
Implications:
- HSN presents a safe and reliable therapeutic option for managing permanent, trauma-induced lower limb spasticity.
- This technique offers a targeted approach to spasticity at the muscle spindle level.
- Further research may explore HSN for other spasticity-related conditions.
