Lidocaine hyperselective motor blocks of the triceps surae nerves - Role of the soleus versus gastrocnemius on triceps spasticity and predictive value of the soleus motor block on the result of selective tibial neurotomy
Lidocaine hyperselective motor blocks of the triceps surae nerves - Role of the soleus versus gastrocnemius on triceps spasticity and predictive value of the soleus motor block on the result of selective tibial neurotomy
复制标题
DOI：
10.1097/phm.0b013e318168bccb
复制
发表时间：
2008-04-01
影响因子：
3
通讯作者：
Decq, Philippe
中科院分区：
文献类型：
--
作者：
Buffenoir, Kevin;Rigoard, Philippe;Decq, Philippe
目的：本前瞻性研究旨在评价两种类型的超选择性运动阻滞(比目鱼肌上神经和腓肠肌神经)引起的临床和步态参数的变化及其对选择性胫骨神经切断术结果的预测能力。设计：7例成年足痉挛患者，男4例，女3例，平均年龄41岁。在每个运动阻滞(比目鱼肌上神经和腓肠肌神经)前后和选择性胫骨神经切断后1mo进行临床(马蹄足评分、踝关节活动范围、痉挛、疼痛和穿鞋舒适度)和步态分析(运动学和肌电参数)评估。结果：比目鱼肌上神经阻滞对临床参数(小腿三头肌伸展反射评分从2.57降至0.9，平均步行时间从44秒降至32.1秒)和运动学参数(由于R3和摆动相减少，步态周期的总持续时间缩短)有效。结论：本研究证实了选择性比目鱼肌上神经运动阻滞的实用价值，并为预测选择性比目鱼肌神经切断术的效果提供了有用的依据。这构成了支持比目鱼肌在痉挛足中的主要作用的另一个论点。
Objectives: This prospective study was designed to evaluate the clinical and gait parameter changes induced by two types of hyperselective motor blocks of the triceps surae nerves (superior soleus and gastrocnemius nerves) and their ability to predict the results of selective tibial neurotomy.Design: Seven adult patients (four males and three females, mean age of 41 yrs old) with spastic foot were included in this study. Clinical (equinus foot score, ankle range of motion, spasticity, pain, and comfort wearing shoes), and gait analysis (kinematic and electromyographic parameters) assessment were performed before and after each motor block (superior soleus nerve and gastrocnemius nerve) and 1 mo after selective tibial neurotomy.Results: The superior soleus nerve block was effective on clinical parameters (triceps surae stretch reflex scores decreased from 2.57 to 0.9, and mean walking time decreased from 44 to 32.1 secs) and on kinematics parameters (the total duration of the gait cycle was decreased because of a reduction of the R3 and swing phases). The same results are observed after soleus neurotomy.Conclusion: This work confirms the practical value of selective superior soleus nerve motor block and that this block provides a useful prediction of the effect of selective soleus neurotomy. It constitutes an additional argument in favor of the predominant role of the soleus in spastic foot.