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      Neurotomía fascicular selectiva en el tratamiento de la espasticidad Translated title: Selective Fascicular Neurotomy in the Treatment of Spasticity

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          Abstract

          La neurotomía fascicular selectiva es una operación que está indicada en los pacientes con espasticidad segmentaria localizada, cuando existe fracaso con el tratamiento farmacológico y de reeducación funcional. La indicación más frecuente es en la garra dolorosa de los ortejos de los pies, el pie equino-varo, la flexión del codo, muñeca y mano en garra. Se presentan 15 operaciones realizadas en 8 pacientes. Las intervenciones fueron de los nervios plantar, tibial, isquiotibial, aductores, mediano y musculocutáneo. Las causas de la espasticidad fueron: lesiones medulares, hidrocefalia congénita, asfixia neonatal, encefalitis, malformación arteriovenosa rota y esclerosis múltiple. En el 86% de las intervenciones se logró el objetivo planteado en el preoperatorio y en el 13% se cumplió parcialmente. En el 100% de los pacientes mejoró la motilidad voluntaria. Todos los pacientes espontáneamente manifestaron una mejoría en su condición

          Translated abstract

          Selective fascicular neurotomy is an effective procedure in the treatment of localized spasticity after the failure of a well-conducted, conservative treatment associating physiotherapy and antispasmodic medications. Selective neurotomy aims at reducing the muscular tone in spastic muscles by a partial section of the motor fascicles of the corresponding nervous branches. Preoperative motor block provided the advantage of "mimicking" the effect of the neurotomy and therefore gave the patients an idea of the expected results of surgery. The present series consists of 15 operations performed on 8 patients suffering from spasticity as a result of lesions of the spinal cord, congenital hydrocephalus, neonatal asphyxia, encephalitis, multiple sclerosis, and arteriovenous malformation hemorrhage. The neurotomies were performed on the median, musculocutaneous, tibial, adductor, and plantar nerves. In 86% of the operations the objective proposed in the preoperative was fully achieved, and in 13% only partially. All patients rated their conditions better than before surgery

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          Most cited references 15

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          Peripheral selective neurotomy of the brachial plexus collateral branches for treatment of the spastic shoulder: anatomical study and clinical results in five patients

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            Physiological effects of selective tibial neurotomy on lower limb spasticity.

             A. Feve,  P Decq,  P Filipetti (1997)
            To assess by electrophysiology the effect of tibial selective neurotomy on muscle imbalance of the spastic ankle.
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              La neurotomía selectiva del nervio tibial para el tratamiento del pie espástico

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                Author and article information

                Affiliations
                [1 ] Instituto de Neurocirugía Asenjo Chile
                [2 ] Universidad de Chile Chile
                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                rchnp
                Revista chilena de neuro-psiquiatría
                Rev. chil. neuro-psiquiatr.
                Sociedad de Neurología, Psiquiatría y Neurocirugía (Santiago )
                0717-9227
                April 2000
                : 38
                : 2
                : 122-125
                S0717-92272000000200007
                10.4067/S0717-92272000000200007

                http://creativecommons.org/licenses/by/4.0/

                Product
                Product Information: SciELO Chile
                Categories
                NEUROSCIENCES
                PSYCHIATRY

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