Highly Selective Partial Neurectomies for Spasticity: A Single-Center Experience.

Area of Science:

• Neurosurgery
• Orthopedics
• Physical Medicine and Rehabilitation

Background:

• Current spasticity treatments like medications and botulinum toxin provide only temporary relief.
• Highly selective partial neurectomies (HSPN) offer a potentially permanent solution for focal spasticity.
• Spasticity management is crucial for improving quality of life in patients with neurological conditions.

Purpose of the Study:

• To evaluate the effectiveness of HSPN in reducing spasticity.
• To assess patient satisfaction following HSPN procedures.
• To quantify changes in spasticity using the Modified Ashworth Scale (MAS).

Main Methods:

• Retrospective review of patients treated with HSPN between 2014 and 2018.
• Inclusion of cases with independently assessed Modified Ashworth Scale (MAS) scores.
• Analysis of pre- and postoperative MAS scores, complications, and patient-reported outcomes.

Main Results:

• A significant reduction in mean MAS scores from 3.6 preoperatively to 1.7 postoperatively (P < .001).
• 91% of patients reported positive outcomes, with excellent satisfaction.
• No perioperative complications were observed in the study cohort.
• The study included 38 patients undergoing 88 procedures, primarily for upper extremity spasticity.

Conclusions:

• HSPN demonstrates objective short- and long-term efficacy in reducing focal spasticity.
• The procedure is associated with minimal morbidity and high patient satisfaction.
• This study represents the first North American series analyzing HSPN for spasticity based on independent evaluations.