The efficacy and safety of Phenol 5% neurolysis in patients with lower limb spasticity

Abstract

The phenol use in spasticity is a recognized treatment but used by only a few group of colleagues. The phenol cost is accessible, but its use needs experience in order to avoid adverse effects like pain, local fibrosis, loss of sensitivity. This study is a retrospective cohort of medical record analysis of patients treated with Phenol 5% neurolysis to lower limbs spasticity from January 2014 to December 2016 in a Brazilian Public General Rehabilitation Center from all the patients that were submitted a Phenol 5% neurolysis to treat lower limbs spasticity from January 2014 to December 2015. The patients submitted to the phenol 5% injections were evaluated in relation to their spasticity by both, Asworth Modified Scale (AMS) and Range of Motion (ROM) from knee flexion/extension and hip extension/abduction. All patients were inquired about side effects (including pain, local reactions and any other comorbidities) thirty days after the injection. One hundred and twenty-eight patients were treated with phenol 5% neurolysis due to lower limbs spasticity. The average age was 27.8 years old, 47 were under 18, being the youngest 4 years old, and 23 were elderly. Seventy-three patients had a cerebral palsy, 38 had a spinal cord injury and 17 a stroke. The treated muscles and nerves were sciatic motor branch nerve ( n = 69), obturator nerve ( n = 74), femoral nerve ( n = 6) and psoas muscle ( n = 35), Seven patients reported moderate pain after the injection in the region of femoral cutaneal nerve (all of them after the obturator injection) with full resolution up to 7 days. Any other side effect was reported. The study concludes that phenol injections are safe and efficient in the lower limbs spasticity treatment.