title: [Spasticity treated with selective posterior rhizotomy].
abstract: BACKGROUND
  Spasticity is often seen in patients with central nervous lesions. Some patients with severe spasticity are not optimally treated with physiotherapy and medication.
  
  
  METHODS
  We present a case history of a 41-year-old woman with multiple sclerosis and severe painful spasticity in her lower limbs. Her spasticity did not respond to treatment with physiotherapy, spasmolytic medication, botulinum toxin A, intrathecal baclofen or epidural spinal cord stimulation.
  
  
  RESULTS
  The patient was treated with selective posterior rhizotomy S1-L1. Section of 60% of the rootlets on the right side and 40% on left the side resulted in a good outcome with less spasticity and pain. Finally her contractures were treated with tenotomy and myotomy, also with good functional result.
  
  
  CONCLUSIONS
  Patients suffering from severe painful spasticity and who do not respond to physiotherapy in combination with other spasmolytic medication should be considered for surgical treatment. In some patients posterior rhizotomy is the treatment of choice.
authors.affiliation: Nevrologisk avdeling, Haukeland Sykehus 5021 Bergen. marit.gronning@haukeland.no
authors.forename: Marit
authors.initials: M
authors.lastname: Grønning
authors.forename: Frode
authors.initials: F
authors.lastname: Svendsen
authors.forename: Håvard
authors.initials: H
authors.lastname: Skeidsvoll
authors.forename: Kari Øen
authors.initials: KØ
authors.lastname: Jones
authors.forename: Per Torgeir
authors.initials: PT
authors.lastname: Nilsen
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D009103:Multiple Sclerosis / Q000601:surgery*; D010264:Paraplegia / Q000601:surgery*; D019051:Rhizotomy / Q000379:methods*; D016896:Treatment Outcome