[Microsurgical drezotomy for spastic limbs].
A microsurgical drezotomy can be useful in some selected cases for the treatment of severe and diffuse spasticity in one or several limbs. This technique has been introduced by M. Sindou in 1972, on the basis of human anatomical studies in the dorsal root entry zone (DREZ). The aim of surgery is to interrupt preferentially the peripheral inputs sustaining myotatic and polysynaptic reflexes which are exaggerated in spasticity, and also nociceptive fibers in the lateral part of the DREZ, whilst sparing most of the medial tactile and kinestetic fibers for the dorsal funiculus. The authors report a retrospective review of 269 patients with severe spasticity in one upper limb (94 cases) treated by a cervical drezotomy, and in one (17 cases) or two lower limbs (158 cases) treated by a lumbosacral drezotomy. The place of this ablative technique inside the neurosurgical armament against spasticity is discussed.
Service de Neurochirurgie A, Hôpital Neurologique et Neurochirurgical P.-Wertheimer, Hospices Civils de Lyon, Université Lyon I. patrick.mertens@chu-lyon.fr
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D001132:Arm / Q000294:innervation / Q000503:physiopathology / Q000601:surgery; D001696:Biomechanical Phenomena; D005121:Extremities / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D007866:Leg / Q000294:innervation / Q000503:physiopathology / Q000601:surgery; D008866:Microsurgery; D009128:Muscle Spasticity / Q000503:physiopathology / Q000601:surgery*; D009412:Nerve Fibers / Q000473:pathology; D019635:Neurosurgical Procedures; D018579:Patient Selection; D011182:Postoperative Care; D012189:Retrospective Studies; D013116:Spinal Cord / Q000601:surgery; D016896:Treatment Outcome