• Asian J Neurosurg · Jan 2020

    Analysis of Surgical Cases of Tarsal Tunnel Syndrome in Our Department: Case Series and Literature Review.

    • Masatoshi Yunoki.
    • Department of Neurosurgery, Kagawa Rosai Hospital, Marugame, Kagaw, Japan.
    • Asian J Neurosurg. 2020 Jan 1; 15 (1): 59-64.

    BackgroundTarsal tunnel syndrome (TTS) is an entrapment neuropathy in which the tibial nerve is compressed within the tarsal tunnel and causes sensory disturbance in the sole of the foot. In this manuscript, we summarized our early surgical cases of TTS.Materials And MethodsSix feet in five patients with TTS were treated surgically. The patients were aged 31-70 years (mean 53.1 years), and all of them complained of pain or dysesthesia of the sole of the foot sparing the heel. Magnetic resonance imaging (MRI) and nerve conduction test were performed preoperatively. In surgery, flexor retinaculum was dissected (tarsal tunnel opening [TTO]), the posterior tibial nerve was freed from the arteriovenous complex (neurovascular decompression [NVD]), and fascia of the abductor hallucis muscle was excised to decompress the medial and lateral plantar nerve (releasing fascial of abductor hallucis muscle [RFAH]).ResultsPreoperative MRI confirmed that all seven cases were idiopathic TTS. Moreover, NCD demonstrated delayed sensory conduction velocity but not delayed distal motor latency. Surgical decompression was beneficial in 5 feet. The recurrence of symptoms was found in one case within 1 postoperative month.ConclusionSurgical treatment for idiopathic TTS with TTO, NVD, and RFAH was generally good. However, symptoms recurred in one instance. Some methods to prevent adhesion and granulation in the reconstructed tarsal tunnel should be considered.Copyright: © 2020 Asian Journal of Neurosurgery.

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