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Outcome and Prognosis of Microsurgical Decompression in Idiopathic Severe Common Fibular Nerve Entrapment: Prospective Clinical Study.
World Neurosurg. 2019 Jun; 126:e281-e287.WN

Abstract

OBJECTIVE

Compression of the common fibular nerve at the level of the fibular neck is considered to be the most frequent lower limb entrapment syndrome, which can be either idiopathic or secondary. Decompressive surgery is indicated only after failure of conservative treatment and/or severe neurologic deficit. The effectiveness of microsurgical decompression has been established only for secondary entrapment syndrome. The aim of this study is to assess the results of microsurgical decompression and establish the prognosis of idiopathic severe common fibular nerve entrapment.

METHODS

Fifteen patients were included in this prospective clinical study and were followed at day 1 after surgery and later at 1, 6, and 12 months. More than half (64.3%) of patients had a total motor deficit (0/5). The median motor function preoperatively was 0/5. The average time of conservative treatment before surgery was 25.7 days (range 5-110 days). One patient refused surgical management.

RESULTS

Thirteen out of 14 patients who underwent surgery showed significant motor function improvement. The median motor strength at 12 months was 4.5/5. Half of the patients regained normal motor function. The only patient who did not improve had the longest time to surgery interval (110 days). The patient who refused surgery showed no improvement (0/5 at 12 months).

CONCLUSIONS

Microsurgical decompression should be considered early in the context of severe idiopathic common fibular nerve entrapment in order to get a favorable outcome.

Authors+Show Affiliations

Department of Neurosurgery, Hotel-Dieu de France Hospital, Beirut, Lebanon.Laboratory of Research in Neurosciences-Faculty of Medicine, Saint Joseph University, Beirut, Lebanon.Laboratory of Research in Neurosciences-Faculty of Medicine, Saint Joseph University, Beirut, Lebanon.Department of Neurology and Neurosurgery-Centre Hospitalier du Nord Hospital, Zgharta, Lebanon.Laboratory of Research in Neurosciences-Faculty of Medicine, Saint Joseph University, Beirut, Lebanon; Department of Neurosurgery, Hotel-Dieu de France Hospital, Beirut, Lebanon; Department of Neurology and Neurosurgery-Centre Hospitalier du Nord Hospital, Zgharta, Lebanon. Electronic address: joseph.maarrawi@usj.edu.lb.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30822592

Citation

Tarabay, Bilal, et al. "Outcome and Prognosis of Microsurgical Decompression in Idiopathic Severe Common Fibular Nerve Entrapment: Prospective Clinical Study." World Neurosurgery, vol. 126, 2019, pp. e281-e287.
Tarabay B, Abdallah Y, Kobaiter-Maarrawi S, et al. Outcome and Prognosis of Microsurgical Decompression in Idiopathic Severe Common Fibular Nerve Entrapment: Prospective Clinical Study. World Neurosurg. 2019;126:e281-e287.
Tarabay, B., Abdallah, Y., Kobaiter-Maarrawi, S., Yammine, P., & Maarrawi, J. (2019). Outcome and Prognosis of Microsurgical Decompression in Idiopathic Severe Common Fibular Nerve Entrapment: Prospective Clinical Study. World Neurosurgery, 126, e281-e287. https://doi.org/10.1016/j.wneu.2019.02.042
Tarabay B, et al. Outcome and Prognosis of Microsurgical Decompression in Idiopathic Severe Common Fibular Nerve Entrapment: Prospective Clinical Study. World Neurosurg. 2019;126:e281-e287. PubMed PMID: 30822592.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Outcome and Prognosis of Microsurgical Decompression in Idiopathic Severe Common Fibular Nerve Entrapment: Prospective Clinical Study. AU - Tarabay,Bilal, AU - Abdallah,Youmna, AU - Kobaiter-Maarrawi,Sandra, AU - Yammine,Pierre, AU - Maarrawi,Joseph, Y1 - 2019/02/26/ PY - 2018/12/16/received PY - 2019/02/10/revised PY - 2019/02/10/accepted PY - 2019/3/2/pubmed PY - 2020/1/14/medline PY - 2019/3/2/entrez KW - Common fibular nerve KW - Drop foot KW - Entrapment syndrome KW - Nerve microsurgical decompression SP - e281 EP - e287 JF - World neurosurgery JO - World Neurosurg VL - 126 N2 - OBJECTIVE: Compression of the common fibular nerve at the level of the fibular neck is considered to be the most frequent lower limb entrapment syndrome, which can be either idiopathic or secondary. Decompressive surgery is indicated only after failure of conservative treatment and/or severe neurologic deficit. The effectiveness of microsurgical decompression has been established only for secondary entrapment syndrome. The aim of this study is to assess the results of microsurgical decompression and establish the prognosis of idiopathic severe common fibular nerve entrapment. METHODS: Fifteen patients were included in this prospective clinical study and were followed at day 1 after surgery and later at 1, 6, and 12 months. More than half (64.3%) of patients had a total motor deficit (0/5). The median motor function preoperatively was 0/5. The average time of conservative treatment before surgery was 25.7 days (range 5-110 days). One patient refused surgical management. RESULTS: Thirteen out of 14 patients who underwent surgery showed significant motor function improvement. The median motor strength at 12 months was 4.5/5. Half of the patients regained normal motor function. The only patient who did not improve had the longest time to surgery interval (110 days). The patient who refused surgery showed no improvement (0/5 at 12 months). CONCLUSIONS: Microsurgical decompression should be considered early in the context of severe idiopathic common fibular nerve entrapment in order to get a favorable outcome. SN - 1878-8769 UR - https://www.unboundmedicine.com/medline/citation/30822592/Outcome_and_Prognosis_of_Microsurgical_Decompression_in_Idiopathic_Severe_Common_Fibular_Nerve_Entrapment:_Prospective_Clinical_Study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1878-8750(19)30453-X DB - PRIME DP - Unbound Medicine ER -