Percutaneous lumbar rhizotomy for spasms in paraplegia

Twenty-one patients with myelopathy causing uncontrollable spasms of the legs underwent percutaneous lumbar rhizotomy. There were two groups: active, otherwise healthy people with spinal lesions whose rehabilitation was hampered by spasms of flexion or extension of the hips and knees; and a second group of hospitalised, debilitated paraplegic patients with unhealing decubitus ulcers. Fourteen of the 16 active patients had excellent results initially, as did all five of the patients with pressure sores. Six have undergone repeat procedures in 7 to 18 months for recurrences of some component of the spasms. All have had at least minor recurrences. Of six patients with significant sensory preservation pre-operatively, four found the resulting numbness disturbing and two did not achieve good relief from the spasms. The procedure is recommended when uncontrollable spasms interfere with rehabilitation or healing of pressure sores in patients with spinal lesions with complete motor and sensory loss.