Surgical Treatment for Spasticity: Selective Dorsal Rhizotomy – Technique and Literature Review

Brazilian Neurosurgery

article

Marcos Paulo dos Santos Teixeira¹  Bernardo Assumpção de Monaco²  Jessie Medeiros de Navarro³  Emmanuel Alejandro Vazquez⁴  Arthur José Maia Lopes⁶  Thais Cristina de Souza Melo⁷  Manoel Jacobsen Teixeira⁸ 

[1] Foundation of Beneficence, Hospital de Cirurgia;Department of Neurosurgery, Hospital das Clínicas, Faculty of Medicine, Universidade de São Paulo;Department of Neurophysiology, Hospital das Clínicas, Faculty of Medicine, Universidade de São Paulo;Department of Neurosurgery, Hospital Aleman de Bueno Aires;Hospital das Clínicas, Faculty of Medicine, University of São Paulo;Neurosurgery Residency, Faculty of Medicine, University of São Paulo;Medical School Graduation, Universidade Federal de Sergipe Aracaju;Neurosurgery Discipline, Hospital das Clínicas, Faculty of Medicine University of São Paulo

关键词: spasticity;    rhizotomy;    cerebral palsy;    electrical stimulation;    surgery;   

DOI  :  10.1055/s-0038-1623514

学科分类：社会科学、人文和艺术（综合）

来源: Thieme

【 摘 要 】

Spasticity is a motor disorder that leads to a resistance to passive joint movement. Cerebral palsy is the most important cause of spasticity and can be caused by several factors, including multiple gestations, alcoholism, infections, hemorrhages, drowning, and traumatic brain injuries, among others. There are many scales that help to measure and monitor the degree of impairment of these patients. The initial treatment should focus on the causal factor, such as tumors, inflammation, degenerative diseases, hydrocephalus, etc. Subsequently, the treatment of spastic musculature includes oral or intrathecal myorelaxants, spinal cord electrostimulation, neurotomies, Lissauer tract lesion, dentatotomy and selective dorsal rhizotomy. The latter is a safe technique, possible to be performed in most centers with neurosurgical support, and it is effective in the treatment of severe spasticity. In this article, the authors describe the surgical technique and conduct a review the literature.

【 授权许可】

CC BY|CC BY-NC-ND