Treatment options for spasticity in children

Abstract

Partial dorsal root rhizotomy and intrathecal administration of baclofen are two modalities used to treat spasticity in children. Each has its own inclusion criteria and mechanism of action. Both have been proven to relieve spasticity, and both have their particular side effects and complications. Programmable pumps for the accurate and reliable administration of intrathecal baclofen are expensive and demand a lifelong commitment to medication refill and hardware reimplantation. Partial dorsal root rhizotomy is a one-time surgical procedure, which differs from one center to another. It requires a team approach for patient selection and to determine whether other treatment options should take precedence. It also requires a period of postoperative reeducation in the form of physiotherapy. While some centers use intraoperative nerve root stimulation and muscle response recording as a guidance tool for rootlet sectioning, others claim equally good results without the added time-consuming technology.