Spinal surgery for spasticity (46 cases)

The authors report their experiences in the surgical treatment of spastic syndromes by operations on the spinal cord and nerve roots. In the authors' neurosurgical department 20 lumbar myelotomies, 19 posterior selective lumbar rhizotomies, 2 complete posterior lumbar rhizotomies, 4 anterior lumbar rhizotomies and five posterior cervical rhizotomies were performed. Clinical results can be considered good on the whole. There was no mortality and no major complication in the entire series. The effect of selective posterior lumbar rhizotomy on the evolution of cerebropathic spastic paraparesis was particularly impressive. Six of 46 patients experienced a late recurrence of spasticity, but they all had good results after a further operation. The particular criteria for selection of each surgical procedure are discussed and related to the aetiology and clinical picture of the spastic syndrome.