title: Role of dorsal rhizotomy in spinal cord injury-induced spasticity.
abstract: Selective dorsal rhizotomy may have a role in the management of spinal cord injury (SCI)-induced spasticity. Spasticity and spasms are common sequelae of SCI in children. Depending on the clinical scenario, treatments may include physical and occupational therapy, oral medications, chemodenervation, and neurosurgical interventions. Selective dorsal rhizotomy (SDR) is used in the management of spasticity in selected children with cerebral palsy, but, to the authors' knowledge, its use has not been reported in children with SCI. The authors describe the cases of 3 pediatric patients with SCI and associated spasticity treated with SDR. Two of the 3 patients have had significant long-term improvement in their preoperative spasticity. Although the third patient also experienced initial relief, his spasticity quickly returned to its preoperative severity, necessitating additional therapies. Selective dorsal rhizotomy may have a place in the treatment of selected children with spasticity due to SCI.
authors: Department of Neurological Surgery, University of Washington, Seattle, Washington;
authors: Renee M
authors: RM
authors: Reynolds
authors: Ryan P
authors: RP
authors: Morton
authors: Marion L
authors: ML
authors: Walker
authors: Teresa L
authors: TL
authors: Massagli
authors: Samuel R
authors: SR
authors: Browd
mesh_terms: D000058:Accidental Falls; D000293:Adolescent; D001418:Baclofen / Q000008:administration & dosage; D002574:Cervical Vertebrae; D002648:Child; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D015918:Infusion Pumps, Implantable; D008297:Male; D009125:Muscle Relaxants, Central / Q000008:administration & dosage; D009128:Muscle Spasticity / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery*; D011782:Quadriplegia / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery*; D019051:Rhizotomy / Q000379:methods*; D013119:Spinal Cord Injuries / Q000150:complications* / Q000209:etiology; D013904:Thoracic Vertebrae; D016896:Treatment Outcome; D014948:Wounds, Gunshot / Q000150:complications
chemical_list: D009125:Muscle Relaxants, Central; D001418:Baclofen
keywords: ADL = activities of daily living; ITB = intrathecal baclofen; SCI = spinal cord injury; SDR = selective dorsal rhizotomy; selective dorsal rhizotomy; spasticity; spinal cord injury; spine