Neurectomies for treatment of stroke-related upper extremity spasticity

Limb spasticity due to central nervous system lesions can lead to substantial functional impairment. This is particularly challenging when the patient retains control of limb movements. This intraoperative video demonstrates selective neurectomies to improve spasticity. The case of a patient with left spastic hemiplegia after stroke who requested peripheral neurectomies for durable treatment of left elbow flexion spasticity is shown. The patient had substantial improvement in resting tone and achieving a relaxed, near-full extension at rest. He retains elbow flexion, which has improved in subsequent clinical follow-up evaluation. Highly selective partial denervation surgery can successfully reduce spasticity. The video can be found here: https://stream.cadmore.media/r10.3171/2022.9.FOCVID22106.