Long-Term Functional Outcome After Surgical Treatment of Peroneal Intraneural Ganglion Cyst

Abstract Background Intraneural ganglia are benign mucinous cystic formations that originate within the epineurium of peripheral nerves. Different treatments have been recommended, with an overall satisfactory outcome. In this paper, we aim to evaluate the long-term outcomes of surgical treatment of peroneal intraneural ganglia by reviewing our local institutional experience. Patients and methods We performed a case series review of peroneal intraneural ganglia surgical treatment performed by senior author. Demographic and surgical details were abstracted from the medical record for each patient. Electrodiagnostic studies and MRI were performed in all patients pre- and postoperatively. Results Eight male patients were enrolled, with an average age at time of surgery of 47.5 years (ranging 28-68 years). Motor testing revealed a preoperative deficit of dorsiflexion, eversion and toe extension in seven patients, with median preoperative MRC 0/5. A sensory loss in the distribution of the CPN was present in seven patients. Mean clinical follow-up time was 113 months (range 32-189 months). Significant pain relief was achieved in all patients. Overall neurologic function was improved, more so for motor function. Median postoperative dorsiflexion, eversion and toe extension at last follow-up were MRC 5/5. No complications occurred postoperatively. There was no clinical evidence of intraneural recurrence, as confirmed in postoperative MRI. In two patients, an extraneural cystic formation was visible in the anterior muscular compartment. Conclusions In summary, the data from our series support excellent long-term postoperative motor outcomes with a low recurrence rate. To avoid extraneural recurrence, resection of superior tibio-fibular joint is necessary.