Neurological Surgery No Shinkei Geka Volume 43, Issue 4 (April 2015)

Clinical Feathers and Treatment of Peroneal Nerve Entrapment Neuropathy Naotaka IWAMOTO 1 , Toyohiko ISU 1 , Yasuhiro CHIBA 1 , Kyongsong KIM 2 , Daijiro MORIMOTO 3 , Kazuyoshi YAMAZAKI 1 , Masanori ISOBE 1 1Department of Neurosurgery, Kushiro Rosai Hospital 2Department of Neurosurgery, Chiba Hokuso Hospital, Nippon Medical School 3Department of Neurosurgery, Nippon Medical School Keyword: peroneal , nerve , entrapment , neuropathy pp.309-316
Published Date 2015/4/10
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 OBJECTIVE:Peroneal nerve entrapment neuropathy(PEN)is generally known as a drop foot with sensory disturbance. However, some patients experience numbness and pain in the affected area without severe paresis due to PEN. We report the clinical features and our surgical results of PEN cases.

 METHODS:We encountered 17 cases of PEN. The patients were 7 females and 10 males and their ages ranged from 30 to 78 years(average 56.1 years). In these cases, conservative therapy was unsuccessful;therefore, we performed surgical treatment for PEN.

 RESULTS:Among the 17 cases, 4 were of bilateral and 13 were of unilateral PEN. There was no severe paresis, as in drop foot;however, mild paresis(4/5, manual muscle test, MMT)was noted in 15 cases. In all cases, intermittent claudication presented, which ranged from 10 to 800m(average 150m). In 13 cases, radiological abnormality of the lumbar region was noted and 8 cases had a history of lumbar surgery(they had failed back surgery syndrome). In all the cases, we performed neurolysis of the peroneal nerve under local anesthesia;there was no surgical complication. After the surgery, symptoms improved, and the numerical rating of the lower limb improved from 8.6/10 to 0.8/10. Intermittent claudication also improved in all of the cases.

 CONCLUSIONS:We successfully treated 17 cases of PEN, which had lower limb pain without severe paresis, as in drop foot. Our results indicate that PEN should be recognized as a cause of intermittent claudication. Neurolysis for PEN under local anesthesia is less invasive and is useful for the treatment of lower limb pain.

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Neurological Surgery 脳神経外科
43巻4号 (2015年4月)
電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院