TY - JOUR
T1 - Intraoperative Nerve Monitoring for Tarsal Tunnel Decompression
T2 - A Surgical Technique to Improve Outcomes
AU - Still, Gregory P.
AU - Pfau, Zeno J.
AU - Cordoba, Aniela
AU - Jupiter, Daniel C.
N1 - Publisher Copyright:
© 2019 the American College of Foot and Ankle Surgeons
PY - 2019/11
Y1 - 2019/11
N2 - The aim of the current study was to evaluate the effectiveness of intraoperative neuromonitoring (INM) as an adjunct in performing tarsal tunnel decompression surgery. We reviewed 38 patients who met inclusion criteria. INM was used to measure the voltage of the abductor hallucis and digiti quinti muscles both before and after decompression. Observed changes intraoperatively were acute and within minutes of the decompression performed by the surgeon. Patient outcomes were ascertained from clinical findings and classified as excellent, fair, or poor. Patient outcomes and the voltage change were measured and assessed for association, and statistically significant differences were found between outcome groups. Of the 38 patients, 29 (76%) had excellent outcomes, with a mean change in microvolts of 2088.28 ± 1172.44 (684%) (p = .0004) and 2173.24 ± 1228.39 (742%) (p = .0014) for abductor hallucis and abductor digiti quinti, respectively. The study supports INM as a useful adjunct in performing tarsal tunnel decompression.
AB - The aim of the current study was to evaluate the effectiveness of intraoperative neuromonitoring (INM) as an adjunct in performing tarsal tunnel decompression surgery. We reviewed 38 patients who met inclusion criteria. INM was used to measure the voltage of the abductor hallucis and digiti quinti muscles both before and after decompression. Observed changes intraoperatively were acute and within minutes of the decompression performed by the surgeon. Patient outcomes were ascertained from clinical findings and classified as excellent, fair, or poor. Patient outcomes and the voltage change were measured and assessed for association, and statistically significant differences were found between outcome groups. Of the 38 patients, 29 (76%) had excellent outcomes, with a mean change in microvolts of 2088.28 ± 1172.44 (684%) (p = .0004) and 2173.24 ± 1228.39 (742%) (p = .0014) for abductor hallucis and abductor digiti quinti, respectively. The study supports INM as a useful adjunct in performing tarsal tunnel decompression.
KW - 4
KW - abductor digiti quinti
KW - abductor hallucis
KW - case series (small cohort study retrospective)
KW - electromyography
KW - lower extremity nerve decompression
KW - nerve integrity monitoring
KW - posterior tibial nerve
KW - tarsal tunnel syndrome
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U2 - 10.1053/j.jfas.2019.04.009
DO - 10.1053/j.jfas.2019.04.009
M3 - Article
C2 - 31679673
AN - SCOPUS:85074272994
SN - 1067-2516
VL - 58
SP - 1203
EP - 1209
JO - Journal of Foot and Ankle Surgery
JF - Journal of Foot and Ankle Surgery
IS - 6
ER -