Neurotomies are procedures that aim to treat focal spasticity, they can be chemical, surgical or percutaneous. It's an option for botulinum toxin application, with prolonged and irreversible results.
The main medication used are Phenol or Absolute Alcohol. It is possible to perform ablative neurotomies with radiofrequency.
The obturator nerve is responsible for the adduction of lower limbs (thigh closure). It is important to treat the spasticity of this region to improve patient hygiene, also making it easier for the caregiver. Scissor gait is common in patients with lower limb spasticity, for example in multiple sclerosis. Neurolisis of the obturator nerve can improve gait in these patients.
Patients with stroke sequelae (stroke sequelae) may present spastic stance of adductors, as well as children with Cerebral Palsy. An expert's assessment becomes necessary to evaluate the best course of action.
Other nerves important for the treatment of spasticity in lower limbs are: tibial, fibular and femoral.
For upper limbs, there are the musculocutaneous nerve, responsible for innervation of the biceps, leaving the spastic upper limb in a bending position. The neurotomy of the musculocutaneous nerve promotes spasticity relief in flexion of the forearm.
Other target nerves for the treatment of focal spasticity of the upper limbs are: radial, ulnar and median nerves.