Síndrome Del Nervio De Baxter
La neuritis de Baxter, síndrome de Baxter o atrapamiento de la primera rama del nervio plantar lateral del pie, también conocida como falsa fascitis plantar, es el dolor por atrapamiento de un nervio que tiene dos ramas, una sensitiva y otra motora.
Este nervio da inervación sensitiva a la zona en la que se origina la fascia plantar, e inervación motora al músculo abductor del 5º dedo del pie. Por esto, cuando se comprime o atrapa, da sintomatología dolorosa en la zona de origen de la fascia y daño en el pequeño músculo que mueve el dedo pequeño del pie. Por dar dolor en esta frecuente zona de aparición de la fascitis plantar, un porcentaje (hasta el 80% según algunos estudios) de las fascitis plantares son en realidad falsas fascitis plantares y el diagnóstico real corresponde a un daño en el nervio. Fue Baxter, un podólogo norteamericano el primero en reseñar este hecho en una publicación científica, y por esto este síndrome lleva su nombre.
Nervio tibial y sus ramas a su paso por el túnel del tarso, diseccionado.BN es el nervio de Baxter.
Síntomas
Dolor en el talón, similar a una fascitis plantar, pero a menudo más acentuado al estar mucho tiempo de pie quieto o en la cama, mientras que las fascitis plantares suelen ser más dolorosas en los primeros pasos de la mañana.
Diagnóstico
El diagnóstico es clínico y ecográfico. Tras visualizar el nervio con ecografía de altísima precisión, suele aparecer dolor al presionarlo. En ocasiones se puede poner una pequeña cantidad de anestésico local en el nervio para ver qué cambios clínicos aparecen y en otras ocasiones se puede hacer un estudio neurofisiológico, no siempre concluyente.
Tratamiento
El tratamiento varía según el estado del nervio, pero generalmente es quirúrgico, mediante cirugía ecoguiada que secciona la fascia profunda del músculo abductor del primer dedo que comprime al nervio. En ocasiones se puede hacer antes una hidrodisección del nervio o una radiofrecuencia ecoguiada, o bien combinar todos los tratamientos.
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