Top

Published in:

01-12-2024 | Rhizotomy | Case Report

Cervical dorsal rhizotomy for upper limbs spasticity. Case report

Authors: Italo Teles de Oliveira Filho, Paulo Cesar Romero, Alexandre Pingarilho Rezende, Bruno Braga Sisnando Costa, Saul Dalla Oliveira, Emílio Afonso França Fontoura, Ricardo Vieira Botelho

Published in: Acta Neurochirurgica | Issue 1/2024

Abstract

Spasticity is a prevalent symptom of upper motor neuron syndrome, becoming debilitating when hindering voluntary movement and motor function and causing contractures and pain. Functional neurosurgery plays a crucial role in treating severe spasticity. Despite extensive literature on SDR for lower limb spasticity, there is a scarcity of papers regarding the procedure in the cervical region to alleviate upper limb spasticity. This case report details a cervical dorsal rhizotomy (CDR) performed for upper limb spasticity, resulting in significant improvement in spasticity with sustained outcomes and low complication rates. Neuroablative procedures like CDR become an option to treat spasticity.

Aquilina K, Graham D, Wimalasundera N (2015) Selective dorsal rhizotomy: an old treatment re-emerging. Arch Dis Child 100(8):798–802. https://doi.org/10.1136/archdischild-2014-306874. (Erratum in: Arch Dis Child. 2017 102(3):278)CrossRefPubMed

Bertelli JA, Ghizoni MF, Michels A (2000) Brachial plexus dorsal rhizotomy in the treatment of upper-limb spasticity. J Neurosurg 93(1):26–32. https://doi.org/10.3171/jns.2000.93.1.0026CrossRefPubMed

Goyal N, Arora S, Kulshreshtha P, Gupta P (2021) Microsurgical DREZotomy in spastic cerebral palsy: poor man’s baclofen pump. World Neurosurg 149:e170–e177. https://doi.org/10.1016/j.wneu.2021.02.055CrossRefPubMed

Guan J, Lin J, Guan X, Jin Q, Zhang W (2021) Contralateral C7 nerve transfer through posterior vertebral approach combined with selective posterior rhizotomy of the affected cervical nerve in the treatment of central upper limb spastic paralysis: a case report. Medicine (Baltimore) 100(12):e25061. https://doi.org/10.1097/MD.0000000000025061CrossRefPubMed

Hong JC, Kim MS, Chang CH, Kim SW, Kim OL, Kim SH (2008) Long term results of microsurgical dorsal root entry zonotomy for upper extremity spasticity. J Korean Neurosurg Soc 43(4):182–185. https://doi.org/10.3340/jkns.2008.43.4.182CrossRefPubMedPubMedCentral

Kan P, Gooch J, Amini A, Ploeger D, Grams B, Oberg W, Simonsen S, Walker M, Kestle J (2008) Surgical treatment of spasticity in children: comparison of selective dorsal rhizotomy and intrathecal baclofen pump implantation. Childs Nerv Syst 24(2):239–243. https://doi.org/10.1007/s00381-007-0457-8CrossRefPubMed

Lynn AK, Turner M, Chambers HG (2009) Surgical management of spasticity in persons with cerebral palsy. PM R 1(9):834–838. https://doi.org/10.1016/j.pmrj.2009.07.016CrossRefPubMed

Madsen PJ, Isaac Chen HC, Lang SS (2018) Neurosurgical approaches. Phys Med Rehabil Clin N Am 29(3):553–565. https://doi.org/10.1016/j.pmr.2018.04.002CrossRefPubMed

Reynolds RM, Morton RP, Walker ML, Massagli TL, Browd SR (2014) Role of dorsal rhizotomy in spinal cord injury-induced spasticity. J Neurosurg Pediatr 14(3):266–270. https://doi.org/10.3171/2014.5.PEDS13459CrossRefPubMed

10.

Romanelli P, Beltramo G (2020) Stereotactic dorsolateral irradiation of spinal nerve roots: a novel technique for the treatment of spasticity and pain. Cureus 12(5):e8323. https://doi.org/10.7759/cureus.8323CrossRefPubMedPubMedCentral

11.

Salame K, Ouaknine GE, Rochkind S, Constantini S, Razon N (2003) Surgical treatment of spasticity by selective posterior rhizotomy: 30 years experience. Isr Med Assoc J 5(8):543–546PubMed

12.

Seruya M (2018) The future of upper extremity spasticity management. Hand Clin 34(4):593–599. https://doi.org/10.1016/j.hcl.2018.07.002CrossRefPubMed

13.

Sindou MP, Mertens P (2000) Neurosurgery for spasticity. Stereotact Funct Neurosurg 74(3–4):217–221. https://doi.org/10.1159/000056483CrossRefPubMed

14.

Sindou M, Mifsud JJ, Boisson D, Goutelle A (1986) Selective posterior rhizotomy in the dorsal root entry zone for treatment of hyperspasticity and pain in the hemiplegic upper limb. Neurosurgery 18(5):587–595. https://doi.org/10.1227/00006123-198605000-00013CrossRefPubMed

15.

Sitthinamsuwan B, Chanvanitkulchai K, Nunta-Aree S, Kumthornthip W, Pisarnpong A, Ploypetch T (2010) Combined ablative neurosurgical procedures in a patient with mixed spastic and dystonic cerebral palsy. Stereotact Funct Neurosurg 88(3):187–192. https://doi.org/10.1159/000313872CrossRefPubMed

16.

Sitthinamsuwan B, Phonwijit L, Khampalikit I, Nitising A, Nunta-Aree S, Suksompong S (2017) Comparison of efficacy between dorsal root entry zone lesioning and selective dorsal rhizotomy for spasticity of cerebral origin. Acta Neurochir (Wien) 159(12):2421–2430. https://doi.org/10.1007/s00701-017-3322-xCrossRefPubMed

17.

Steinbok P (2007) Selective dorsal rhizotomy for spastic cerebral palsy: a review. Childs Nerv Syst 23(9):981–990. https://doi.org/10.1007/s00381-007-0379-5CrossRefPubMed

Title: Cervical dorsal rhizotomy for upper limbs spasticity. Case report
Authors: Italo Teles de Oliveira Filho
Paulo Cesar Romero
Alexandre Pingarilho Rezende
Bruno Braga Sisnando Costa
Saul Dalla Oliveira
Emílio Afonso França Fontoura
Ricardo Vieira Botelho
Publication date: 01-12-2024
Publisher: Springer Vienna
Keyword: Rhizotomy
Published in: Acta Neurochirurgica / Issue 1/2024
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-024-06041-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Cervical dorsal rhizotomy for upper limbs spasticity. Case report

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 1/2024

Factors influencing slippage after microsurgical single level lumbar spinal decompression surgery - Are the psoas and multifidus muscles involved? -

Anatomical damages in the spinal nerve roots and the spinal cord after brachial plexus injury: descriptive study from a cohort of consecutive patients who underwent DREZ-lesioning for pain—practical implications

Hematocrit drift and outcomes in surgical patients with aneurysmal subarachnoid hemorrhage

Efficacy and safety of percutaneous balloon compression for bilateral trigeminal neuralgia: a retrospective study

Correction to: Anterior surgical treatment for cervical degenerative radiculopathy: a prediction model for non‑success

Overlapping stimulation of subthalamic nucleus and dentato-rubro-thalamic tract in Parkinson’s disease after deep brain stimulation