Surgical Treatments

Operations involving the nervous system (neurosurgery) and the bones, tendons, and muscles (orthopedic surgery) are both used to treat spasticity and, in properly selected patients, can play a very important role in the treatment of chronic spasticity. Patients who have a recent injury to the brain or spinal cord will have changes in their muscle tone that come and go during the recovery period. Surgery should not be undertaken during this time. Treating children with spasticity is particularly challenging because their spasticity may change as they grow and develop. At times, an operation may be undertaken to allow more normal bone and muscle growth.

In many cases, a combination of neurosurgical and orthopedic operations may be undertaken. While each surgical approach has certain strengths and weaknesses, none completely eliminate spasticity or its effects. Surgery should not be seen as a last resort when other treatments have failed. Instead, surgery may be considered when a permanent reduction is needed in muscle tone or when muscle force needs to be redirected.

Patients with chronic spasticity should have a thorough evaluation of their current level of function, and realistic expectations for improvement in function should be established before the operation takes place. As with any other spasticity treatment, surgical intervention must be incorporated into an overall spasticity management plan. An ongoing physical therapy program following surgery is important to maximize the benefits available from the operation.

	Neurosurgery for Spasticity