Peroneal nerve entrapment is a syndrome in which compression of the common peroneal nerve and its major branches causes a series of symptoms and signs. Patients with complete common peroneal nerve injury walk with a foot drop in a straddle gait, with sensory deficits in the lateral and dorsal calf, with deficits in bunion, toe extension, dorsal foot extension, foot inversion, and atrophy of the anterolateral calf muscle group. So, what are the common problems of common peroneal nerve entrapment syndrome? The following are the common problems of common peroneal nerve entrapment syndrome.
1.What is common peroneal nerve entrapment syndrome?
The human lateral knee bones and tendons and other connective tissues constitute a normal physiological narrow channel, called the peroneal canal. The peroneal canal is lined by the common peroneal nerve. The common peroneal nerve innervates the sensation of the anterolateral aspect of the lower leg, the dorsum of the foot, and the movement of the foot and toe lift. Any cause of pathological narrowing of the peroneal canal and increased pressure in the peroneal canal can cause entrapment of the common peroneal nerve or produce neurological dysfunction, called common peroneal nerve entrapment syndrome. The causes of common peroneal nerve entrapment syndrome include: knee trauma, inflammation of the peroneal canal, peroneal canal tumor, knee strain, knee compression due to incorrect posture, diabetes mellitus, etc.
2. Clinical manifestations of common peroneal nerve entrapment syndrome
Numbness, hypesthesia or loss of sensation in the anterolateral calf and dorsum of the foot, weak toe extension and foot drop.
3.How to confirm the diagnosis of common peroneal nerve entrapment syndrome?
There is anterolateral calf, dorsal foot sensory numbness, weakness of foot lift and toe extension, foot drop Neurological examination with positive signs abnormal peroneal nerve electromyography at the knee to exclude serious lesions of the arteries and veins of the lower extremities to exclude serious lumbar spondylosis.
4.What is the current status of treatment of common peroneal nerve entrapment syndrome?
Some early patients with mild symptoms can be treated with non-surgical treatment, such as rest, painkillers, anti-inflammatory drugs, physiotherapy, etc. Patients with more severe symptoms or those who have not been treated conservatively for 2 weeks can be treated surgically. Microdecompression of the common peroneal nerve in the lateral peroneal canal of the knee is the most advanced minimally invasive surgical method at present.
5.The main danger of common peroneal nerve entrapment syndrome
Increasing numbness seriously affects the patient’s quality of life foot ptosis affects the patient’s walking and gait in the late stage can lead to foot disuse and recalcitrant ulcer formation.
6.What kind of patients with common peroneal nerve entrapment syndrome are suitable for surgical treatment?
Diagnosed with common peroneal nerve entrapment syndrome with severe symptoms, conservative treatment for 2 weeks is ineffective.
7.How is microdecompression of the common peroneal nerve performed?
The incision is made under local anesthesia or lumbar anesthesia and is only a few centimeters long. Microdecompression is performed by microscopically relieving the compression of the common peroneal nerve in the peroneal canal by muscles, tendons, ligaments and other connective tissues to improve symptoms such as numbness and weakness of the limb. The procedure has the advantages of short time, less bleeding, less complications, less pain and quicker results.
8.Surgical effect of microdecompression of common peroneal nerve
The relief rate of sensory disorder of the lower limbs can reach 95%, but the recovery of motor function is slightly worse, 90% of patients recover the normal motor function of the foot. It is emphasized that the earlier the surgery, the better the effect.
9. Possible side effects and complications of microdecompression of the common peroneal nerve
Delayed wound healing and infection 1% insignificant symptom relief 5% recurrence of symptoms 2% peroneal nerve collateral damage 1%.
10.Difference between microdecompression of common peroneal nerve and traditional peroneal canal decompression
The entire surgery is performed by a neurosurgeon under a high magnification surgical microscope plus intra-neural release, more complete decompression, less likely to recur, and the application of advanced bipolar electrocoagulator, more complete hemostasis and improved efficacy and reduced complications.
11.Surgical cost and time of microdecompression of common peroneal nerve
Surgery time 30 minutes hospitalization total cost 5000 yuan hospitalization time 7 days.
12.Preparation work needed before coming to Beijing for surgery
1）Stable medical condition.
2）No edema in the limb.
3）Electromyography results of the common peroneal nerve at the knee.
(4) Arteriovenous ultrasound results of the affected limb.
(5) Imaging results of the lumbar spine.