Article

OBJECTIVE: To present practice patterns for phenol neurolysis procedures
conducted for spasticity management. DESIGN: A retrospective review of 185
persons with spasticity who underwent phenol neurolysis procedures (n = 293) at
an academic rehabilitation hospital and clinic. Patient demographics, concomitant
spasticity treatments, and procedure relevant information were collected.
RESULTS: The cohort included 71.9% males and 61.6% inpatient procedures.
Neurological diagnoses included stroke (41.0%), traumatic brain injury (28.6%)
and spinal cord injury (24.3%). Musculoskeletal diagnoses included spastic
hemiplegia or paresis (51.3%), tetraplegia (38.4) and paraplegia (9.2%). At the
time of phenol neurolysis, most patients (77.5%) received concomitant
pharmacological treatments for spasticity. Injection guidance modalities included
electrical stimulation and ultrasound (69.3%) or ultrasound only (27.3%). A mean
of 3.48 ml of phenol were injected per nerve and 10.95 ml of phenol were used per
procedure. Most commonly injected nerves included the obturator nerve (35.8%) and
sciatic branches to the hamstrings and adductor magnus (27.0%). Post-phenol
neurolysis assessment was recorded in 54.9% of encounters, in which 84.5%
reported subjective benefit.
Post-procedure adverse events included pain (4.0%),
swelling and inflammation (2.7%), dysaesthesia (0.7%)
and hypotension (0.7%).
CONCLUSION: Phenol neurolysis is currently used to reduce spasticity for various
functional goals, including preventing contractures and improving gait. Depending
on the pattern of spasticity displayed, numerous peripheral nerves in the upper
and lower extremities can be targeted for treatment with phenol neurolysis.
Further research into its role in spasticity management, including studies exploring its cost-effectiveness and pharmacological and side-effects compared
with other treatment options are needed.

Langue : ANGLAIS