An Orthopedic Perspective on the Management of Spasticity

Neurologic conditions such as brain injuries, cerebral palsy, stroke and multiple sclerosis involve injury of upper motor neurons, which can manifest as spasticity. The resulting hypertonicity and imbalance of forces between muscle groups leads to deformities that impair patient function and can cause significant long-term complications. Symptoms of spasticity can be managed with nonoperative techniques such as physiotherapy, bracing, or medications. Other approaches such as intrathecal baclofen pumps and selective dorsal rhizotomy have also demonstrated efficacy in controlling spasticity. Spasticity that has failed nonoperative management can be treated with orthopedic surgeries that correct deformities by either restoring joint anatomy or re-balancing the forces of spastic muscle groups. Improved mobility and reduced pain after these procedures can help patients with their rehabilitation, function, and independence.