Selective peripheral neurotomy (SPN) as a treatment strategy for spasticity

Abstract

Spasticity can be caused by central nervous system dysfunction, such as cerebral palsy and stroke. The accepted pathogenesis of spasticity is that the muscles are in the state of uninhibited stretch reflex without enough control of central nervous system. So far, there is no ideal way about how to repair central nervous system. However, the uninhibited stretch reflex can be reduced, targeting the posterior root of the spinal cord and peripheral nerves innervating the limbs, which are called selective posterior rhizotomy (SPR) and selective peripheral neurotomy (SPN), respectively. SPN is indicated for focal or multifocal spasticity, which is well accepted due to its low invasiveness and ease of use. How does the operation work? What do we do before and during this operation? Is there any risk to the patients? Our review summarizes the mechanism, indications, preoperative assessments, techniques, and complications of SPN. We hope that the spastic patients, such as pediatric cerebral palsy patients and older stroke patients, will benefit from this surgery.

Negative Air Environment-Induced Rehabilitation of Spasticity And Behavior During Physiotherapy in Cerebral Palsy Patients

“…Spasticity can aggravate and joints may become immovable because of rigidity if timely interventions are not provided [14]. Several interventions to treat spasticity including anticonvulsant medicines, bimanual training, botulinum toxins, bisphosphonates, context-focused therapies, hip surveillance, fitness training, goal-directed training, home interventions, occupational therapies, and selective dorsal rhizotomy have been reported [15,16]. In earlier studies, we reported the assertive effects of environmental enrichment techniques and Al Fatiha administration on the behavioral and physical outcomes in spastic CP-inflicted patients [17,18].…”