Publication: Improvement of sitting ability and ambulation status after selective peripheral neurotomy of the sciatic hamstring nerve together with obturator branches for severe spasticity of the lower extremities
Issued Date
2012-10-01
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ISSN
14230372
10116125
10116125
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2-s2.0-84864198690
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Mahidol University
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SCOPUS
Bibliographic Citation
Stereotactic and Functional Neurosurgery. Vol.90, No.5 (2012), 335-343
Suggested Citation
Bunpot Sitthinamsuwan, Kannachod Chanvanitkulchai, Luckchai Phonwijit, Sarun Nunta-Aree, Witsanu Kumthornthip, Teerada Ploypetch Improvement of sitting ability and ambulation status after selective peripheral neurotomy of the sciatic hamstring nerve together with obturator branches for severe spasticity of the lower extremities. Stereotactic and Functional Neurosurgery. Vol.90, No.5 (2012), 335-343. doi:10.1159/000338679 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/14603
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Title
Improvement of sitting ability and ambulation status after selective peripheral neurotomy of the sciatic hamstring nerve together with obturator branches for severe spasticity of the lower extremities
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Abstract
Background: The authors used selective peripheral neurotomy (SPN) on the sciatic and obturator nerves to restore the sitting posture and ambulation in bedridden patients suffering from severe proximal lower limb spasticity. Objective: To study the surgical outcome of sciatic and obturator neurotomies. Methods: All patients with refractory hamstring spasticity who encountered SPN on the hamstring nerve were recruited. Obturator neurotomy was undertaken in some individuals. The clinical assessment included Modified Ashworth Scale (MAS), passive range of motion (PROM), sitting competency and ambulatory condition. These parameters were compared between before and after the surgery by using the Wilcoxon signed-rank test. Results: Among the sciatic neurotomy group (n = 15), the mean pre- and postoperative MAS and PROM were 3.3 and 0.8 (p < 0.01) and 78.3 and 121.7° (p < 0.01), respectively. Those measurements of the obturator nerve surgery group (n = 11) were 3.7 and 1.1 (p < 0.01) as well as 21.0 and 45.0° (p < 0.01), respectively. Seven and 8 of a total of 9 patients had statistically significant improvement in sitting ability (p = 0.016) and ambulation status (p < 0.01), respectively. Conclusion: Bedridden patients who suffer from severe proximal lower limb spasticity have an optimum to return to sitting and ambulate with a wheelchair after SPN of the sciatic and obturator nerves. Copyright © 2012 S. Karger AG, Basel.