Long term results of microsurgical dorsal root entry zonotomy for upper extremity spasticity.
OBJECTIVE
The purpose of the present study is to assess the long-term results of microsurgical dorsal root entry zonotomy (MDT) for the treatment of medically intractable upper-extremity spasticity.


METHODS
The records of nine adult patients who underwent MDT by one operating neurosurgeon from March 1999 to June 2004 were retrospectively reviewed by another investigator who had no role in the management of these patients. In all patients, MDT was performed on all roots of the upper limb (from C5 to T1) for spasticity of the upper extremity. The degree of spasticity was measured by the Modified Ashworth Scale (grade 0-4). Severity of the pain level was determined using the Numeric Rating Scale (NRS, score 0-10). Also, patient satisfaction of the post-operative outcome was assessed.


RESULTS
Comparing the preoperative and postoperative spasticity using the Modified Ashworth Scale, we observed improvement in all patients, particularly in five of the nine patients (55.6%) who improved by three grades over an average of 66.4 months (range, 40-96). Regarding patient satisfaction, seven patients (77.8%) had affirmative results. None of the patients experienced severe, life-threatening, postoperative complications. We observed a decrease in the intensity of painful spasms to less than three scores as measured by NRS in all four patients with associated pain.


CONCLUSIONS
This study shows that MDT provides significant, long-term reduction of harmful spasticity and associated pain in the upper limbs.
Hong
Joo-Chul
JC
Department of Neurosurgery, College of Medicine, Yeungnam University, Daegu, Korea.
Kim
Min-Soo
MS
Chang
Chul-Hoon
CH
Kim
Sang-Woo
SW
Kim
Oh-Lyong
OL
Kim
Seong-Ho
SH