• Kathleen R Ran, Oishika Das, David T Johnston, Neha Vutakuri, Sruthi Ranganathan, Mustafa Broachwala, Harman Chopra, Long AzadChaoCDepartment of Plastic and Reconstructive Surgery, Johns Hopkins Hospital, Baltimore, Maryland, USA., Tej D Azad, Shenandoah Robinson, Allan J Belzberg, Sami H Tuffaha, and Daniel Lubelski.
• Department of Neurosurgery, Johns Hopkins Hospital, Baltimore, Maryland, USA. Electronic address: kran2@jh.edu.
• World Neurosurg. 2024 Jul 1; 187: 104113104-113.

AbstractSpasticity is a potentially debilitating symptom of various acquired and congenital neurologic pathologies that, without adequate treatment, may lead to long-term disability, compromise functional independence, and negatively impact mental health. Several conservative as well as non-nerve targeted surgical strategies have been developed for the treatment of spasticity, but these may be associated with significant drawbacks, such as adverse side effects to medication, device dependence on intrathecal baclofen pumps, and inadequate relief with tendon-based procedures. In these circumstances, patients may benefit from nerve-targeted surgical interventions such as (i) selective dorsal rhizotomy, (ii) hyperselective neurectomy, and (iii) nerve transfer. When selecting the appropriate surgical approach, preoperative patient characteristics, as well as the risks and benefits of nerve-targeted surgical intervention, must be carefully evaluated. Here, we review the current evidence on the efficacy of these nerve-targeted surgical approaches for treating spasticity across various congenital and acquired neurologic pathologies.Copyright © 2024 Elsevier Inc. All rights reserved.

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