Surgical treatment of spasticity

Abstract

Spasticity is generated by a functional reorganization of spinal circuits after a lesion on modulatory systems of movement and sensitive interactions. It maybe worsened by sensitive, nociceptive stimuli, citokynes elevation and emotions. Evaluation of the spasticity is based on patient history and on the physical examination, emphasizing the neurological deficits and aggravating factors as well as the possible complications specially the scars and disturbances of the muscle skeletal system. Treatment of spasticity is based
on rehabilitation, prevention of complications and improvement of the motor function. Among the antispastic agents, baclofen and the diazepam are the most commonly used. We must cite the superselective neurotomies, superselective rhizotomies, tractotomy of Lissauer,
spinal posterior horn coagulation and the myelotomies as the main ablative procedures used for treatment of spasticity. Intratecal drug infusion devices are also important treatment
choices when there is still motor function.