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Dynamic factors involved in common peroneal nerve entrapment neuropathy.
Acta Neurochir (Wien). 2017 Sep; 159(9):1777-1781.AN

Abstract

BACKGROUND

Common peroneal nerve (CPN) entrapment neuropathy (CPNEN) is the most common peripheral neuropathy of the lower extremities. The pathological mechanisms underlying CPNEN remain unclear. We sought to identify dynamic factors involved in CPNEN by directly measuring the CPN pressure during stepwise CPNEN surgery.

METHODS

We enrolled seven patients whose CPNEN improved significantly after CPN neurolysis. All suffered intermittent claudication, and the repetitive plantar flexion test, used as a CPNEN provocation test, was positive. During decompression surgery we directly measured the CPN pressure during several decompression steps.

RESULTS

Before CPN decompression, plantar flexion elicited a statistically significant increase in the CPN pressure (from 1.8 to 37.3, p < 0.05), as did plantar extension (from 1.8 to 23.1, p < 0.05). The CPN pressure gradually decreased during step-by-step surgery; it was lowest after resection of the peroneus longus muscle (PLM) fascia.

CONCLUSIONS

Dynamic factors affect idiopathic CPNEN. The CPN pressure decreased at each surgical decompression step, and removal of the PLM fascia resulted in adequate decompression of the CPN. Our findings shed light on the etiology of idiopathic CPNEN and recommend adequate CPNEN decompression procedures.

Authors+Show Affiliations

Department of Neurosurgery, Nippon Medical School, Tokyo, 113-8603, Japan.Department of Neurosurgery, Chiba Hokuso Hospital, Nippon Medical School, 1715, Kamagari, Inzai-city, Chiba, 270-1694, Japan. kyongson@nms.ac.jp.Department of Neurosurgery, Nippon Medical School, Tokyo, 113-8603, Japan.Department of Neurosurgery, Chiba Hokuso Hospital, Nippon Medical School, 1715, Kamagari, Inzai-city, Chiba, 270-1694, Japan.Department of Neurosurgery, Teikyo University Hospital, Tokyo, 173-8606, Japan.Department of Neurosurgery, Kushiro Rosai Hospital, Hokkaido, 085-8533, Japan.Department of Neurosurgery, Nippon Medical School, Tokyo, 113-8603, Japan.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28702813

Citation

Kitamura, Takao, et al. "Dynamic Factors Involved in Common Peroneal Nerve Entrapment Neuropathy." Acta Neurochirurgica, vol. 159, no. 9, 2017, pp. 1777-1781.
Kitamura T, Kim K, Morimoto D, et al. Dynamic factors involved in common peroneal nerve entrapment neuropathy. Acta Neurochir (Wien). 2017;159(9):1777-1781.
Kitamura, T., Kim, K., Morimoto, D., Kokubo, R., Iwamoto, N., Isu, T., & Morita, A. (2017). Dynamic factors involved in common peroneal nerve entrapment neuropathy. Acta Neurochirurgica, 159(9), 1777-1781. https://doi.org/10.1007/s00701-017-3265-2
Kitamura T, et al. Dynamic Factors Involved in Common Peroneal Nerve Entrapment Neuropathy. Acta Neurochir (Wien). 2017;159(9):1777-1781. PubMed PMID: 28702813.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Dynamic factors involved in common peroneal nerve entrapment neuropathy. AU - Kitamura,Takao, AU - Kim,Kyongsong, AU - Morimoto,Daijiro, AU - Kokubo,Rinko, AU - Iwamoto,Naotaka, AU - Isu,Toyohiko, AU - Morita,Akio, Y1 - 2017/07/12/ PY - 2017/06/14/received PY - 2017/06/27/accepted PY - 2017/7/14/pubmed PY - 2018/12/19/medline PY - 2017/7/14/entrez KW - Dynamic factor KW - Entrapment neuropathy KW - Neurolysis KW - Peroneal nerve SP - 1777 EP - 1781 JF - Acta neurochirurgica JO - Acta Neurochir (Wien) VL - 159 IS - 9 N2 - BACKGROUND: Common peroneal nerve (CPN) entrapment neuropathy (CPNEN) is the most common peripheral neuropathy of the lower extremities. The pathological mechanisms underlying CPNEN remain unclear. We sought to identify dynamic factors involved in CPNEN by directly measuring the CPN pressure during stepwise CPNEN surgery. METHODS: We enrolled seven patients whose CPNEN improved significantly after CPN neurolysis. All suffered intermittent claudication, and the repetitive plantar flexion test, used as a CPNEN provocation test, was positive. During decompression surgery we directly measured the CPN pressure during several decompression steps. RESULTS: Before CPN decompression, plantar flexion elicited a statistically significant increase in the CPN pressure (from 1.8 to 37.3, p < 0.05), as did plantar extension (from 1.8 to 23.1, p < 0.05). The CPN pressure gradually decreased during step-by-step surgery; it was lowest after resection of the peroneus longus muscle (PLM) fascia. CONCLUSIONS: Dynamic factors affect idiopathic CPNEN. The CPN pressure decreased at each surgical decompression step, and removal of the PLM fascia resulted in adequate decompression of the CPN. Our findings shed light on the etiology of idiopathic CPNEN and recommend adequate CPNEN decompression procedures. SN - 0942-0940 UR - https://www.unboundmedicine.com/medline/citation/28702813/Dynamic_factors_involved_in_common_peroneal_nerve_entrapment_neuropathy_ L2 - https://dx.doi.org/10.1007/s00701-017-3265-2 DB - PRIME DP - Unbound Medicine ER -