caa a22 4500 463179390 CHVBK 20180406164834.0 cr unu---uuuuu 170326e20070901xx s 000 0 eng 10.1007/s00381-007-0399-1 doi (NATIONALLICENCE)springer-10.1007/s00381-007-0399-1 Selective peripheral neurotomy (SPN) for spasticity in childhood [Elektronische Daten] [M. Sindou, F. Simon, P. Mertens, P. Decq] Overview: Excess spasticity leads to disability that is marked by impaired locomotion, handicapping deformities and, if not controlled, discomfort and pain. Selective peripheral neurotomy in the child is indicated for severe focal spasticity, when botulinum toxin injections cannot delay surgery any longer. Materials and methods: Preoperative motor blocks mimicking the outcome of the surgical procedure are essential to establish the objectives of neurotomy. In the lower limb, obturator neurotomy is indicated for spasticity in the adductor muscles, hamstring neurotomy for the knee flexion and tibial neurotomy for the spastic foot. Anterior tibial neurotomy is indicated for the extensor hallucis spasticity and femoral neurotomy for spasticity in the quadriceps. In the upper limb, neurotomy of the pectoralis major and teres major nerves is indicated for spasticity of the internal rotators of the shoulder. Neurotomy of the musculocutaneous nerve is indicated for spasticity of the flexors of the elbow, and neurotomy of median and ulnar nerves are indicated for spasticity of the pronators and flexors of the wrist and fingers. Conclusion: Selective peripheral neurotomy is a valuable neurosurgical procedure in well-trained surgical hands for severe focalised spasticity. Springer-Verlag, 2007 Spasticity nationallicence Child nationallicence Ablative neurosurgical procedure nationallicence Functional neurosurgery nationallicence Selective neurotomy nationallicence Peripheral nerve nationallicence Sindou M. Department of Neurosurgery, Hôpital Neurologique Pierre Wertheimer, Université Claude-Bernard Lyon I, 59 Bd Pinel, 69003, Lyon, France aut Simon F. Department of Neurosurgery, Hôpital Neurologique Pierre Wertheimer, Université Claude-Bernard Lyon I, 59 Bd Pinel, 69003, Lyon, France aut Mertens P. Department of Neurosurgery, Hôpital Neurologique Pierre Wertheimer, Université Claude-Bernard Lyon I, 59 Bd Pinel, 69003, Lyon, France aut Decq P. Service de Neurochirurgie, Hôpital universitaire Henri Mondor, 94010, Créteil cedex, France aut Child's Nervous System Springer-Verlag 23/9(2007-09-01), 957-970 0256-7040 23:9<957 2007 23 381 https://doi.org/10.1007/s00381-007-0399-1 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00381-007-0399-1 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Sindou M. Department of Neurosurgery, Hôpital Neurologique Pierre Wertheimer, Université Claude-Bernard Lyon I, 59 Bd Pinel, 69003, Lyon, France aut NATIONALLICENCE 700 1- Simon F. Department of Neurosurgery, Hôpital Neurologique Pierre Wertheimer, Université Claude-Bernard Lyon I, 59 Bd Pinel, 69003, Lyon, France aut NATIONALLICENCE 700 1- Mertens P. Department of Neurosurgery, Hôpital Neurologique Pierre Wertheimer, Université Claude-Bernard Lyon I, 59 Bd Pinel, 69003, Lyon, France aut NATIONALLICENCE 700 1- Decq P. Service de Neurochirurgie, Hôpital universitaire Henri Mondor, 94010, Créteil cedex, France aut NATIONALLICENCE 773 0- Child's Nervous System Springer-Verlag 23/9(2007-09-01), 957-970 0256-7040 23:9<957 2007 23 381 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer