Hip Joint Neurolysis in a Patient with Cerebral Palsy - An Alternative Option for Pain Management

Hip joint disorders are frequently observed in patients with cerebral palsy (CP) due to static encephalopathy, dyskinesia and spasticity. Surgical treatments have shown improved pain relief, but sometimes, due to comorbid conditions, they are not feasible. Hip joint neurolysis is a palliative pain procedure that destroys the sensory nerves responsible for hip joint pain. We present a case of a 23-year-old girl with severe spastic CP, who presented to the pain clinic with severe left hip joint pain. Her surgical reconstruction for hip dislocation was planned, but due to anaesthesia risk and post-procedure morbidities, her mother requested non-surgical options. At the pain clinic, a diagnostic block of the anterior articular sensory nerve of the hip joint (left femoral and obturator) was done to provide 80% pain relief. After 2 weeks, a neurolytic block with 90% alcohol was then performed on the articular nerves of the left hip joint, providing 90% pain relief during routine care activities.