Selective tibial nerve neurotomy is known as an effective method to reduce focal spasticity when medical treatment including botulinum toxin is not sufficient. The tibial nerve can be targeted to treat spastic equinovarus foot with (or without) claw toes.

Tibial nerve trunk is dissected in the popliteal fossa. Sensitive and motor branches are identified using Electrostimulation to monitor motor responses. The muscular nerves corresponding to the targeted muscles are partially sectioned according to a preoperative chart. A postoperative rehabilitation program is mandatory 1).


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1)
Dauleac C, Sindou M, Mertens P. How I do it: selective tibial neurotomy. Acta Neurochir (Wien). 2020 Aug;162(8):1921-1923. doi: 10.1007/s00701-020-04314-9. Epub 2020 May 7. PMID: 32377951.
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