Neurectomy

About Neurectomy

A neurectomy, or selective peripheral neurectomy, is a procedure in which a motor nerve root is partially or fully cut to permanently reduce its ability to signal a specific muscle. Where rhizotomy works on sensory nerves in the spine, neurectomy works on motor nerves closer to the muscle itself.

How it works

Motor nerves carry signals from the spinal cord out to the muscles, telling them to contract. In a selective peripheral neurectomy, the surgeon identifies the branch of the motor nerve that supplies the overactive muscle and cuts a portion of it. This permanently weakens the signal to that muscle and reduces the spasticity.

The surgeon typically cuts only a percentage of the nerve fibers, so the muscle still has function but is less tight. Intraoperative nerve stimulation helps confirm the right nerve branch before cutting.

Who is a candidate

Neurectomy is most useful when spasticity is very focal, meaning it's concentrated in one or two specific muscles, and often when dystonia is present as well. Common examples include spasticity in the hip adductors or calf muscle (gastrocnemius) on one or both sides. It is sometimes used when injections have been effective, but the family wants a longer-lasting solution.

What to expect after surgery

Recovery is generally quicker than rhizotomy. Most children go home the same or next day. Therapy afterward focuses on strengthening the affected area and adapting to the reduced tone. The spasticity reduction is permanent.