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Antispastic therapy with botulinum toxin type A in patients with traumatic spinal cord lesion

Ulrich J Spiegl¹, Doris Maier², Oliver Gonschorek²

¹Berufsgenossenschaftliche Unfallklinik - Traumacenter Murnau, Germany ; Department of Orthopedic and Trauma Surgery, University of Leipzig, Germany.

GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW

|October 28, 2015

Abstract

Objectives:

The purpose of this study was to determine the effect of botulinum toxin injections for the treatment of spasticity after traumatic spinal cord injury.

Methods:

9 patients were included in this prospective designed study, with a follow-up of at least 2 years. All patients suffered from a massive spasticity after traumatic spinal cord lesion. Conservative treatment options did not show satisfying results. All patients were injected a maximal dose of 2,000 units of botulinum toxin A in no more than 6 skeletal muscle groups. Clinical control examinations were performed after 2 weeks and after at least 2 years.

Results:

6 patients reported a good or very good result. One patient offered increasing difficulty in walking for a short time after injection. 2 patients showed no beneficial effects. One patient experienced a modest temporary general weakness for 3 days. After 2 years, 3 patients showed improved function with persistent reduction of spasticity. In the other cases, the beneficial effect lasted for an average of 9 months.

Conclusion:

Botulinum toxin A injection seems to be an effective complementary therapy option in the treatment of spasticity of paraplegic patients with complete deficit of their motor function (ASIA A and B) and a spastic distribution pattern, effecting only a limited number of muscle groups. Caution has to be recommended for incomplete paretic patients, who are able to walk.

Keywords:

botulinum toxin spacticity traumatic spinal cord lesion

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