Selective Peripheral Neurotomy

Overview

A selective peripheral neurotomy is a procedure used by physicians at the Mass General Paralysis Center to restore hand and arm movement and improve walking. This procedure is typically performed on patients who have experienced brain or spinal cord injury due to stroke, tumor or trauma. The procedure can also help patients suffering from cerebral palsy or multiple sclerosis. Patients who suffer from any of those conditions, are be examined by our doctors to determine if this procedure is right for them.

In conditions of spasticity, fists become clenched, wrists will flex and arms can be difficult to straighten. Similarly, feet can turn in and toes curl, making walking challenging.

A selective peripheral neurotomy is used to relax overactive muscles to allow the other muscles that have better control to work without this interference. The operation is performed under a microscope, and it trims nerves that contribute to spastic and dysfunctional limbs. Typically, the function of the spastic muscle is preserved but the overactivity is notably reduced.

When a portion of the nerve is cut, the muscle is weakened and the signals that are getting relayed back to the spinal cord are reduced, and that reduces spasticity. During a selective peripheral neurotomy, though, a portion of the nerve is left intact to avoid paralysis.

Comparison to Botox^®

Some patients choose Botox treatments as a method of relieving spasms. Patients who do this are usually candidates for a selective peripheral neurotomy. This procedure is a more precise, effective and longer lasting alternative to Botox injections.

Recovery

Selective peripheral neurotomy is a relatively simple procedure and the effects are immediate. The sutures are absorbable, which means special post-op care is not required.

Rehabilitation typically starts just 72 hours after the procedure.