[Spasticity treated with selective posterior rhizotomy].
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.
Grønning
Marit
M
Nevrologisk avdeling, Haukeland Sykehus 5021 Bergen. marit.gronning@haukeland.no
Svendsen
Frode
F
Skeidsvoll
Håvard
H
Jones
Kari Øen
KØ
Nilsen
Per Torgeir
PT
D000328:Adult; D005260:Female; D006801:Humans; D009103:Multiple Sclerosis / Q000601:surgery*; D010264:Paraplegia / Q000601:surgery*; D019051:Rhizotomy / Q000379:methods*; D016896:Treatment Outcome