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.

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.