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Clinical Features and Surgical Treatment of Superficial Peroneal Nerve Entrapment Neuropathy.
Neurol Med Chir (Tokyo) 2018; 58(7):320-325NM

Abstract

Superficial peroneal nerve (S-PN) entrapment neuropathy (S-PNEN) is comparatively rare and may be an elusive clinical entity. There is yet no established surgical procedure to treat idiopathic S-PNEN. We report our surgical treatment and clinical outcomes. We surgically treated 5 patients (6 sites) with S-PNEN. The 2 men and 3 women ranged in age from 67 to 91 years; one patient presented with bilateral leg involvement. Mean post-operative follow-up was 25.3 months. We recorded their symptoms before- and at the latest follow-up visit after surgery using a Numerical Rating Scale and the Japan Orthopedic Association score to evaluate the affected area. We microsurgically decompressed the affected S-PN under local anesthesia without a proximal tourniquet. We made a linear skin incision along the S-PN and performed wide S-PN decompression from its insertion point at the peroneal tunnel to the peroneus longus muscle (PLM) to the point where the S-PN penetrated the deep fascia. One patient who had undergone decompression in the area of a Tinel-like sign at the initial surgery suffered symptom recurrence and required re-operation 4 months later. We performed additional extensive decompression to address several sites with a Tinel-like sign. All 5 operated patients reported symptom improvement. In patients with idiopathic S-PNEN, neurolysis under local anesthesia may be curative. Decompression involving only the Tinel area may not be sufficient and it may be necessary to include the area from the PLM to the peroneal nerve exit point along the S-PN.

Authors+Show Affiliations

Department of Neurosurgery, Kushiro Rosai Hospital.Department of Neurosurgery, Kushiro Rosai Hospital.Department of Neurosurgery, Chiba Hokuso Hospital.Department of Neurosurgery, Kushiro Rosai Hospital.Department of Neurosurgery, Kushiro Rosai Hospital.Department of Neurosurgery, Kushiro Rosai Hospital.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29925720

Citation

Matsumoto, Juntaro, et al. "Clinical Features and Surgical Treatment of Superficial Peroneal Nerve Entrapment Neuropathy." Neurologia Medico-chirurgica, vol. 58, no. 7, 2018, pp. 320-325.
Matsumoto J, Isu T, Kim K, et al. Clinical Features and Surgical Treatment of Superficial Peroneal Nerve Entrapment Neuropathy. Neurol Med Chir (Tokyo). 2018;58(7):320-325.
Matsumoto, J., Isu, T., Kim, K., Iwamoto, N., Yamazaki, K., & Isobe, M. (2018). Clinical Features and Surgical Treatment of Superficial Peroneal Nerve Entrapment Neuropathy. Neurologia Medico-chirurgica, 58(7), pp. 320-325. doi:10.2176/nmc.oa.2018-0039.
Matsumoto J, et al. Clinical Features and Surgical Treatment of Superficial Peroneal Nerve Entrapment Neuropathy. Neurol Med Chir (Tokyo). 2018 Jul 15;58(7):320-325. PubMed PMID: 29925720.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical Features and Surgical Treatment of Superficial Peroneal Nerve Entrapment Neuropathy. AU - Matsumoto,Juntaro, AU - Isu,Toyohiko, AU - Kim,Kyongsong, AU - Iwamoto,Naotaka, AU - Yamazaki,Kazuyoshi, AU - Isobe,Masanori, Y1 - 2018/06/20/ PY - 2018/6/22/pubmed PY - 2018/12/20/medline PY - 2018/6/22/entrez KW - decompression KW - nerve entrapment KW - superficial peroneal nerve SP - 320 EP - 325 JF - Neurologia medico-chirurgica JO - Neurol. Med. Chir. (Tokyo) VL - 58 IS - 7 N2 - Superficial peroneal nerve (S-PN) entrapment neuropathy (S-PNEN) is comparatively rare and may be an elusive clinical entity. There is yet no established surgical procedure to treat idiopathic S-PNEN. We report our surgical treatment and clinical outcomes. We surgically treated 5 patients (6 sites) with S-PNEN. The 2 men and 3 women ranged in age from 67 to 91 years; one patient presented with bilateral leg involvement. Mean post-operative follow-up was 25.3 months. We recorded their symptoms before- and at the latest follow-up visit after surgery using a Numerical Rating Scale and the Japan Orthopedic Association score to evaluate the affected area. We microsurgically decompressed the affected S-PN under local anesthesia without a proximal tourniquet. We made a linear skin incision along the S-PN and performed wide S-PN decompression from its insertion point at the peroneal tunnel to the peroneus longus muscle (PLM) to the point where the S-PN penetrated the deep fascia. One patient who had undergone decompression in the area of a Tinel-like sign at the initial surgery suffered symptom recurrence and required re-operation 4 months later. We performed additional extensive decompression to address several sites with a Tinel-like sign. All 5 operated patients reported symptom improvement. In patients with idiopathic S-PNEN, neurolysis under local anesthesia may be curative. Decompression involving only the Tinel area may not be sufficient and it may be necessary to include the area from the PLM to the peroneal nerve exit point along the S-PN. SN - 1349-8029 UR - https://www.unboundmedicine.com/medline/citation/29925720/Clinical_Features_and_Surgical_Treatment_of_Superficial_Peroneal_Nerve_Entrapment_Neuropathy_ L2 - https://dx.doi.org/10.2176/nmc.oa.2018-0039 DB - PRIME DP - Unbound Medicine ER -