Percutaneous selective RF neurotomy in spasticity.

Percutaneous selective radiofrequency (RF) neurotomy is described in the treatment of spasticity dominant in femoral adductor and gastrocnemius muscles. The effectiveness of neurotomy has been tested by means of infiltration of nerves with local anesthetic agents before neurotomy in one case. A temperature monitoring needle electrode system with 5 mm noninsulated tip has been used for localization of the nerves by stimulation. Percutaneous obturator neurotomy was performed in the most proximal portion accessible. Posterior tibial neurotomy was performed in two branches of the nerve which innervates the medial and lateral heads of gastrocnemius. Four lesions lasting 60 seconds were made in four different directions between 65 degrees and 70 degrees.