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The surgical treatment of spasticity
Author(s) -
Chambers Henry G.
Publication year - 1997
Publication title -
muscle and nerve
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.025
H-Index - 145
eISSN - 1097-4598
pISSN - 0148-639X
DOI - 10.1002/(sici)1097-4598(1997)6+<121::aid-mus8>3.0.co;2-b
Subject(s) - spasticity , rhizotomy , medicine , neurosurgery , neurectomy , muscle contracture , weakness , spinal cord , surgery , anesthesia , pathology , alternative medicine , psychiatry
The surgical treatment of spasticity has been aimed at four different levels: the brain, the spinal cord, peripheral nerves, and the muscle. Stereotactic neurosurgery whether involving the globus pallidum, ventrothalamic nuclei, or the cerebellum, has had little success. Cerebellar pacemakers have been tried: results have been mixed but not ultimately encouraging. Selective posterior rhizotomy is currently the most widely used and effective central nervous system procedure. Posterior rootlets in L2‐S2 are exposed and tested with electrical stimutation. Those showing abnormal response are transected. Contraindications include weskness and marked fixed contracture. Neurectormy has been tried for spasticity but the result have not been encouraging and the adverse effects may be severe. Musculoskeletal surgery remains an important precedure for treatment of contractures secondary to spasticity. © 1997 John Wiley & Sons, Inc. Spasticity: Etiology, Evaluation, Management, and the Role of Botulinum Toxin Type A, MF Brin, editor. Muscle Nerve 1997;20(suppl 6):S208‐S220.