Clinical Recovery of Spastic Finger Flexion Using Hyperselective Neurectomy: A Case Series

Area of Science:

• Neurosurgery
• Peripheral Nerve Surgery
• Rehabilitation Medicine

Background:

• Spasticity following upper motor neuron injuries significantly impairs quality of life and hand function.
• Hyperselective neurectomy (HSN) is an advanced peripheral nerve ablation technique.
• HSN offers the potential to relieve spasticity while preserving crucial hand function.

Purpose of the Study:

• To present the surgical technique and outcomes of HSN specifically targeting the flexor digitorum superficialis (FDS) branch.
• To evaluate the efficacy of HSN in managing spastic finger flexion.
• To assess the impact of HSN on pain and hand function in patients with spasticity.

Main Methods:

• HSN of the FDS was performed on 18 patients with functional hands.
• The Peraut categorization was used to assess pain reduction.
• The House categorization was employed to evaluate improvements in hand function.

Main Results:

• Patients showed significant improvement in finger spasticity post-HSN.
• Hand function was preserved, with House Scores increasing from 0-2 pre-surgery to 4-8 post-intervention.
• All patients reported relief from pain associated with spasticity.

Conclusions:

• HSN of the FDS branch is a viable surgical option for reducing finger flexor spasticity.
• The procedure effectively preserves finger flexion function.
• HSN should be considered for patients experiencing spastic finger flexion and seeking improved hand function and pain relief.