Spasticity

Spasticity

It is a condition in which muscles of 1 or more limbs may be tight, even neck muscles & muscles of trunk may be affected, which will result in difficulty to carry out normal movements of the affectedmonoparesis 1 limb muscles may be tight,

part. E.g.in monoparesis 1 limb muscles may be tight, in hemiparesis- one sided upper & lower limb will be affected, in paraparesis both lower limbs will be difficult to move, in quadruparesis all 4 limbs will be affected.



  • Congenital - Cerebral palsy, Congenital brain or spine malformation.
  • Truamatic- Head Injury, Spine Injury.
  • Inflammatory- Infection of brain ( eg. encephalities, meningitis), Spine- arachnoiditis, meningitis.
  • Tumours- Of brain & Spine (spasticity +/_weakness) etc. etc.

Medicines/physiotherapy to relieve spasticity.

If not totally controlled with medicines than operations.


Operatios -

  • Tendon or muscle release.
  • Muscles cut.
  • Nerves/roots cut.
  • Spinal cord surgery.

Brain Surgery- Centre of brain lesioned by Strereotactic or other operations; centre is stimulted by deep brain stimulator(implanted by strereotactic method or others).

Radio Frquency Opertion - In which under IITV guidance Spinal nerve roots of Lumbar regions of 1 or both sides are lesioned & spasticity is relieved.

RF Operations- For Spasticity it is minimally invasive procedure, done in few hours, with great success rate, Patient is discharged in a day. He is advised for physiotherapy & electric stimulation for follow up at home.This operation is done on one side for spasticity on one side (ipsilateral Lumbar nerves), or on both sides if spasticity is bilateral.

Around 30 RF operations are done successfully in spastic patients with various causes with good results.


Mr. A.- 20 years old met with an road traffic accident, followed by unconsciousness & diffuse axonal injury. He was on ventilator for 1 month. After 1 yera he developed hydrocephalus, spasticity all 4 limbs. He could hardly stand with support of 3 persons. He was operated for VP shunt for drainage of CSF (due to hydrocephalus), but his spasticity did not improved. After 2 years of accident he had severe spasticity both lower limbs, can stand with support of 3 persons (two holding from shoulders & one holding knees), & can be dragged to walk. Bilateral Lumbar Spinal nerves selective spinal rhizotomy was done under IITV guidance under general anaesthesia with Radio-Frequecy Lesion Generator (RFLG).Hospital stay was for 2-3 days, it was a minimal invasive procedure. Immediately post-operative he could stand himself without support of relatives.With physiotherapy he continued to improve & at the end of 6-12 months he was walking with walker. After 5 years follow up, he was still walking independantly with walker.

Thus Selective Lumbar spinal rhizotomy is a minimally invasive procedure done under IITV guidance, with excellent results, no stitches, patient can be discharged next day, & charge is very less than that of open surgery.


Spasticity- Cervical Spine injury
Spasticity- Stroke

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