Safety and Potential Efficacy of Selective Dorsal Rhizotomy in Adults with Spinal Cord Injury-Induced Spasticity: An Open-Label, Non-Randomized, Single-Arm Trial

Oraee-Yazdani, Saeed; Tavanaei, Roozbeh; Rezaee-Naserabad, Seyyed Saeed; Khannejad, Samin; Zendehrood, Siamak Alizadeh; Yazdani, Kaveh Oraii; Zali, Alireza

doi:10.1016/j.wneu.2022.11.127

Cited by 2 publications

(2 citation statements)

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“…In 2023, one small nonrandomized prospective study in 10 patients with cervical and thoracic spinal cord injury demonstrated the safety of selective dorsal rhizotomy, and all patients showed improvement in function and spasticity in secondary outcomes. 13 Of note, patients with severe spasticity often develop joint contractures, and it may be difficult to determine whether spasticity or contracture is the cause of the reduced range of motion. In spasticity, a reasonable dose of botulinum toxin should, even if only slightly and transiently, improve the range of motion of the joint.…”

Section: Commentmentioning

confidence: 99%

“…This technique has been used for decades in patients with spastic cerebral palsy but has not been widely used in patients with spinal cord injuries. In 2023, one small nonrandomized prospective study in 10 patients with cervical and thoracic spinal cord injury demonstrated the safety of selective dorsal rhizotomy, and all patients showed improvement in function and spasticity in secondary outcomes 13 …”

Section: Spasticitymentioning

confidence: 99%

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Symptomatic Treatment of Myelopathy

Chuang

2024

CONTINUUM: Lifelong Learning in Neurology

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Objective This article discusses the effects of myelopathy on multiple organ systems and reviews the treatment and management of some of these effects. Latest Developments Recent advances in functional electrical stimulation, epidural spinal cord stimulation, robotics, and surgical techniques such as nerve transfer show promise in improving function in patients with myelopathy. Ongoing research in stem cell therapy and neurotherapeutic drugs may provide further therapeutic avenues in the future. Essential Points Treatment for symptoms of spinal cord injury should be targeted toward patient goals. If nerve transfer for upper extremity function is considered, the patient should be evaluated at around 6 months from injury to assess for lower motor neuron involvement and possible time limitations of surgery. A patient with injury at or above the T6 level is at risk for autonomic dysreflexia, a life-threatening condition that presents with elevated blood pressure and can lead to emergent hypertensive crisis. Baclofen withdrawal due to baclofen pump failure or programming errors may also be life-threatening. Proper management of symptoms may help avoid complications such as autonomic dysreflexia, renal failure, heterotopic ossification, and fractures.

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Section: Commentmentioning

confidence: 99%

Section: Spasticitymentioning

confidence: 99%