Long-term outcomes of selective tibial neurotomy for spastic foot deformity: Initial clinical experience in Vietnam.

INTRODUCTION

Spastic foot deformity after central nervous system lesions is clinically heterogeneous and often combines equinus, varus, claw toes, pain, and gait limitation. Selective tibial neurotomy (STN) is a peripheral neurosurgical option for focal lower-limb spasticity, but data from low- and middle-income settings remain limited.

RESEARCH QUESTION: What are the long-term clinical and functional outcomes of STN for spastic foot deformity, and are these outcomes influenced by the extent of motor fascicle resection?

MATERIAL AND

METHODS

We conducted a retrospective study of 31 patients (36 feet) who underwent STN. Deformity, clonus, ankle dorsiflexion, pain, gait performance, orthotic comfort, and patient satisfaction were assessed preoperatively and at long-term follow-up. The relationship between fascicle resection extent and outcomes was analysed.

RESULTS

Significant improvements were observed in equinus, varus, and claw-toe deformities, ankle dorsiflexion, and clonus (all p < 0.001). Pain resolved in all symptomatic patients, and toe-tip skin lesions markedly decreased. Walking distance increased significantly, and 10-m walking time improved. Orthotic comfort and patient satisfaction were high. Resection of more than two-thirds of fascicles was associated with better clonus and varus control.

DISCUSSION AND

CONCLUSION

STN provides sustained clinical and functional benefits for spastic foot deformity. Greater fascicle resection may enhance outcomes in selected patients. This technique is feasible and effective in a Vietnamese neurosurgical setting.