PMID: 11918648Mar 29, 2002Paper

The surgical management of spasticity

European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies
Y LazorthesJ-C Verdié

Abstract

Neurosurgery is only considered for severe spasticity following the failure of noninvasive management (adequate medical and physical therapy). The patients are carefully selected, based on rigorous multidisciplinary clinical assessment. In this we evaluate the contribution of the spasticity to the disability and any residual voluntary motor function. The goals for each patient are: (a) improvement of function and autonomy; (b) control of pain; and (c) prevention of orthopaedic disorders. To achieve these objectives, the surgical procedure must be selective and reduce the excessive hypertonia without suppressing useful muscle tone and limb functions. The surgical procedures are: (1) Classical neuro-ablative techniques (peripheral neurotomies, dorsal rhizotomies) and their modern modifications using microsurgery and intra-operative neural stimulation (dorsal root entry zone: DREZotomy). These techniques are destructive and irreversible, with the reduced muscle tone reflecting the nerve topography. It is mainly indicated when patients have localized spasticity without useful mobility. (2) Conservative techniques based on a neurophysiological control mechanism. These procedures are totally reversible. The methods involve chronic ne...Continue Reading

References

Jul 1, 1979·Journal of Neurosurgery·B S Nashold, R H Ostdahl
Jan 1, 1991·European Journal of Clinical Pharmacology·B Sallerin-CauteR Bastide
Mar 1, 1990·Journal of Neurosurgery·Y LazorthesJ P Carillo
Aug 1, 1989·Journal of Neurology, Neurosurgery, and Psychiatry·G OchsP Weinmann
Jun 8, 1989·The New England Journal of Medicine·R D PennJ S Kroin
Nov 2, 1985·Lancet·D DralleN Klug
Jun 1, 1987·Journal of Neurology·H MüllerO Hoffmann
Apr 1, 1985·Journal of Neurosurgery·G Barolat-RomanaW Wenninger
May 12, 1984·Lancet·R D Penn, J S Kroin
Mar 29, 2002·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·G Abbruzzese

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Citations

Feb 26, 2013·The Journal of Spinal Cord Medicine·Ahmad Zaheer Qureshi, Subramanya Adiga
Mar 1, 2006·Vojnosanitetski pregled. Military-medical and pharmaceutical review·Predrag PerićStojanka Arsić
May 24, 2006·Neuroscience Letters·Michael P HefferanMartin Marsala
Feb 6, 2004·American Journal of Physical Medicine & Rehabilitation·Steven P CohenLee Moroz
Feb 16, 2008·Nihon yakurigaku zasshi. Folia pharmacologica Japonica·Yuko AndoYasuhito Uezono
Dec 17, 2005·American Journal of Physical Medicine & Rehabilitation·Suheda BayramOrhan Ozcan
Dec 2, 2005·Stereotactic and Functional Neurosurgery·Gokmen KahilogullariYucel Kanpolat
May 8, 2018·The Journal of Hand Surgery Asian-Pacific Volume·Li Yenn YongWee Leon Lam
Dec 17, 2015·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Mohamed I BarakatIbrahim Metwaly
Dec 20, 2008·Journal of Korean Neurosurgical Society·Joo-Chul HongSeong-Ho Kim
Jul 4, 2017·Neurosurgical Focus·Justin M BrownBob S Carter
Mar 11, 2020·Frontiers in Bioengineering and Biotechnology·Nojoud AlHakeemShihab Asfour

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