An Orthopedic Perspective on the Management of Spasticity

Area of Science:

• Neurology
• Orthopedic Surgery
• Rehabilitation Medicine

Background:

• Neurologic conditions like stroke and cerebral palsy injure upper motor neurons, leading to spasticity.
• Spasticity causes hypertonicity and muscle imbalance, resulting in deformities that impair function and lead to complications.
• Effective management of spasticity is crucial for patient outcomes.

Purpose of the Study:

• To review the management of spasticity resulting from upper motor neuron injury.
• To discuss nonoperative and surgical treatment options for spasticity.
• To highlight the benefits of spasticity management on patient function and independence.

Main Methods:

• Review of nonoperative techniques including physiotherapy, bracing, and medications.
• Discussion of surgical interventions such as intrathecal baclofen pumps, selective dorsal rhizotomy, and orthopedic surgeries.
• Analysis of treatment efficacy in controlling spasticity and correcting deformities.

Main Results:

• Nonoperative methods offer symptom management for spasticity.
• Intrathecal baclofen pumps and selective dorsal rhizotomy show efficacy in spasticity control.
• Orthopedic surgery effectively corrects deformities in refractory spasticity cases.

Conclusions:

• A spectrum of treatments exists for spasticity, from conservative to surgical.
• Surgical interventions provide options for spasticity that has not responded to nonoperative management.
• Successful spasticity treatment improves patient mobility, reduces pain, and enhances independence.