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2015 ; 55
(8
): 669-73
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Microsurgical Decompression for Peroneal Nerve Entrapment Neuropathy
#MMPMID26227056
Morimoto D
; Isu T
; Kim K
; Sugawara A
; Yamazaki K
; Chiba Y
; Iwamoto N
; Isobe M
; Morita A
Neurol Med Chir (Tokyo)
2015[]; 55
(8
): 669-73
PMID26227056
show ga
Peroneal nerve entrapment neuropathy (PNEN) is one cause of numbness and pain in
the lateral lower thigh and instep, and of motor weakness of the extensors of the
toes and ankle. We report a less invasive surgical procedure performed under
local anesthesia to treat PNEN and our preliminary outcomes. We treated 22
patients (33 legs), 7 men and 15 women, whose average age was 66 years. The mean
postoperative follow-up period was 40 months. All patients complained of pain or
paresthesia of the lateral aspect of affected lower thigh and instep; all
manifested a Tinel-like sign at the entrapment point. As all had undergone
unsuccessful conservative treatment, we performed microsurgical decompression
under local anesthesia. Of 19 patients who had undergone lumbar spinal surgery
(LSS), 9 suffered residual symptoms attributable to PNEN. While complete symptom
abatement was obtained in the other 10 they later developed PNEN-induced new
symptoms. Motor weakness of the extensors of the toes and ankle [manual muscle
testing (MMT) 4/5] was observed preoperatively in 8 patients; it was relieved by
microsurgical decompression. Based on self-assessments, all 22 patients were
satisfied with the results of surgery. PNEN should be considered as a possible
differential diagnosis in patients with L5 neuropathy due to lumbar degenerative
disease, and as a causative factor of residual symptoms after LSS. PNEN can be
successfully addressed by less-invasive surgery performed under local anesthesia.
|*Decompression, Surgical
[MESH]
|*Neurosurgical Procedures
[MESH]
|Female
[MESH]
|Humans
[MESH]
|Microsurgery
[MESH]
|Middle Aged
[MESH]
|Peripheral Nervous System Diseases/*surgery
[MESH]