An Anatomical Study of the Calcaneal Nerve in the Tarsal Tunnel

Yasunaga, Takashi; Kudo, Yohei; Yamashita, K.; Kinone, Kazunori; Tachibana, Shigekuni; Nishijima, Yoji

doi:10.2531/spinalsurg.23.164

Cited by 2 publications

(2 citation statements)

References 7 publications

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“…[1,2] Although the anatomy is highly variable, the posterior tibial nerve typically divides into three terminal branches, the medial plantar, the lateral plantar, and the medial calcaneal nerve. [8,9] The medial calcaneal branches arise from the tibial nerve, or occasionally from the LPN. [8,9] Because it branches before entering TTS, sensory disturbance of TTS mostly spare the heel.…”

Section: About Tarsal Tunnel Syndromementioning

confidence: 99%

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Analysis of surgical cases of tarsal tunnel syndrome in our department: Case series and literature review

Yunoki¹

2020

Asian J Neurosurg

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Background: Tarsal 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 Methods: Six 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]). Results: Preoperative 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. Conclusion: Surgical 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.

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Section: About Tarsal Tunnel Syndromementioning

confidence: 99%

“…[8,9] The medial calcaneal branches arise from the tibial nerve, or occasionally from the LPN. [8,9] Because it branches before entering TTS, sensory disturbance of TTS mostly spare the heel. [8] TTS was first reported in 1962 by Keck and Lam in two independent publications.…”

Section: About Tarsal Tunnel Syndromementioning

confidence: 99%

Analysis of surgical cases of tarsal tunnel syndrome in our department: Case series and literature review

Yunoki¹

2020

Asian J Neurosurg

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Neurovascular Decompression Techniques for Idiopathic Tarsal Tunnel Syndrome

Tajiri,

Kim,

Isu

et al. 2024

Spinal Surgery

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Background：Surgical treatment for tarsal tunnel syndrome (TTS) remains a topic of controversy. To address this, we performed neurovascular decompression for TTS and reported on the techniques used, as well as the patient characteristics and outcomes pre-and post-surgery. Method：Between April 2021 and September 2022, 43 instances of neurovascular decompression were performed in 27 patients (12 men and 15 women) in our institute. The average postoperative follow-up period was 10.9 months (2-20 months) . Post-operative symptoms were assessed using a numerical rating scale (NRS) . Surgery involved making a 3-cm skin incision, as well as cutting the branch of the posterior tibial artery to obtain vascular mobility. For the secure decompressing of the nerve, posterior tibial artery transfer to the malleolus or heel side was performed by suturing with 5-0 PDS. Care was taken to maintain the traction of the branches of the posterior tibial nerve by the transferred artery. Patients did not require postoperative bed rest or external fixation.Outcome：For the transposition of the posterior tibial artery, dissection of the arterial branch was required in all cases, while cutting of the bridging veins over the artery was required in 9 sides (21%) . In 8 sides (19%) , small nerve branches were observed during surgery. Twenty-five patients reported symptom abatement, while two did not improve. The mean NRS score changed from 6.8 to 1.5. Conclusion：Close attention must be paid to artery meandering and nerve branch traction after arterial transposition under the targeted surgical field to ensure secure nerve decompression in patients undergoing surgical treatment for TTS.

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An Anatomical Study of the Calcaneal Nerve in the Tarsal Tunnel

Cited by 2 publications

References 7 publications

Analysis of surgical cases of tarsal tunnel syndrome in our department: Case series and literature review

Analysis of surgical cases of tarsal tunnel syndrome in our department: Case series and literature review

Neurovascular Decompression Techniques for Idiopathic Tarsal Tunnel Syndrome

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