{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T07:40:08Z","timestamp":1758872408725,"version":"3.44.0"},"reference-count":7,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\nBackground: <\/jats:title>\nSpasticity is a disabling condition, usually present as a manifestation of upper motor neuron syndrome. It can be diffuse, focal, or multifocal, and the treatment should be individualized considering the factors as type, cause, progression over time, as well as joints and muscles functionality.<\/jats:p>\n<\/jats:sec>\n\nCase Description: <\/jats:title>\nWe present the case of a 35-year-old female patient developing a left-sided multifocal spasticity following the bleeding of an arteriovenous malformation 5 years ago. Unfortunately, the patient presented progressive symptoms over the years which were refractory to different medical treatments. Considering no muscle contractures, no definitive joint deformities, the existence of antagonist muscles functionality, as well as a multifocal scenario, we performed a selective peripheral neurotomy to the most affected nerves. Under the guidance of intraoperative neurophysiological monitoring and employing microsurgical techniques, we approached nerve branches of the musculocutaneous and median nerve in the upper limb, and the tibial nerve in the lower limb. During the procedure, it was already possible to see changes in the electroneuromyography and reduction of muscle tone. The patient presented improvement of symptoms in the 1st<\/jats:sup> days following the procedure, with a significant decrease in abnormal flexor tone of the affected muscles.<\/jats:p>\n<\/jats:sec>\n\nConclusion: <\/jats:title>\nCareful preoperative neurological examination is essential to plan the most accurate surgical strategy, and rehabilitation adherence is mandatory for a favorable long-term outcome. Patient consented to the procedure and publication of this operative video.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni_746_2025","type":"journal-article","created":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T07:18:58Z","timestamp":1758871138000},"page":"408","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Selective peripheral neurotomy for multifocal spasticity: Two-dimensional operative video"],"prefix":"10.25259","volume":"16","author":[{"given":"Dong","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Aviation General Hospital, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yongjian","family":"Jin","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Aviation General Hospital, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guilherme Henrique","family":"Weiler Ceccato","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Mackenzie Evangelical University Hospital, Curitiba, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yonghui","family":"Jiao","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Aviation General Hospital, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2025,9,26]]},"reference":[{"key":"10.25259\/SNI_746_2025\/ref-1","doi-asserted-by":"crossref","first-page":"30","DOI":"10.26599\/BSA.2020.9050003","article-title":"Selective peripheral neurotomy (SPN) as a treatment strategy for spasticity","volume":"6","author":"Fan","year":"2020","journal-title":"Brain Sci Adv"},{"key":"10.25259\/SNI_746_2025\/ref-2","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1007\/978-3-030-58505-1_9","article-title":"Post-stroke spasticity","volume-title":"Clinical pathways in stroke rehabilitation: Evidence-based clinical practice recommendations","author":"Francisco","year":"2021"},{"key":"10.25259\/SNI_746_2025\/ref-3","doi-asserted-by":"crossref","first-page":"588","DOI":"10.55275\/JPOSNA-2022-588","article-title":"Use of hyperselective neurectomy in the management of the pediatric spastic upper extremity","volume":"4","author":"Hysong","year":"2022","journal-title":"J Pediatr Orthop Soc North Am"},{"key":"10.25259\/SNI_746_2025\/ref-4","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1302\/2058-5241.2.160074","article-title":"The role of neurectomy in the management of spasticity of the upper limb","volume":"2","author":"Mikalef","year":"2017","journal-title":"EFORT Open Rev"},{"key":"10.25259\/SNI_746_2025\/ref-5","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1046\/j.1468-1331.2001.00042.x","article-title":"Classification of gait patterns in spastic hemiplegia and spastic diplegia: A basis for a management algorithm","volume":"8","author":"Rodda","year":"2001","journal-title":"Eur J Neurol"},{"key":"10.25259\/SNI_746_2025\/ref-6","doi-asserted-by":"crossref","first-page":"957","DOI":"10.1007\/s00381-007-0399-1","article-title":"Selective peripheral neurotomy (SPN) for spasticity in childhood","volume":"23","author":"Sindou","year":"2007","journal-title":"Childs Nerv Syst"},{"key":"10.25259\/SNI_746_2025\/ref-7","doi-asserted-by":"crossref","first-page":"437","DOI":"10.2106\/00004623-198769030-00016","article-title":"Gait patterns in spastic hemiplegia in children and young adults","volume":"69","author":"Winters","year":"1987","journal-title":"J Bone Joint Surg Am"}],"container-title":["Surgical Neurology International"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/surgicalneurologyint.com\/selective-peripheral-neurotomy-for-multifocal-spasticity-two-dimensional-operative-video\/","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/selective-peripheral-neurotomy-for-multifocal-spasticity-two-dimensional-operative-video\/","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T07:19:00Z","timestamp":1758871140000},"score":1,"resource":{"primary":{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/selective-peripheral-neurotomy-for-multifocal-spasticity-two-dimensional-operative-video\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,26]]},"references-count":7,"alternative-id":["10.25259\/SNI_746_2025"],"URL":"https:\/\/doi.org\/10.25259\/sni_746_2025","relation":{},"ISSN":["2152-7806","2229-5097"],"issn-type":[{"value":"2152-7806","type":"electronic"},{"value":"2229-5097","type":"print"}],"subject":[],"published":{"date-parts":[[2025,9,26]]},"article-number":"408"}}