The Problem of Spasticity in the Management of the Spinal Cord-injured Patient and Its Treatment with Special Reference to Percutaneous Radiofrequency Thermal Selective Sensory Rhizotomy

Sequelae of SCI After Discharge from the Initial Rehabilitation Program

“…Spasticity/joint limitations: Coleman ( 1976), Merritt ( 1981 ), and Toth (1983) reported urinary tract infections, urinary stones, bowel impaction, pressure sores, contractures, and other medical problems are associated with an increased inci dence of spasticity after an SCI. Subjects in the study by Better et al (1979) Young et al's (1982) study, 15% of subjects experienced spasticity.…”

Spasticity Management in Spinal Cord Injury

“…The importance of this approach is stressed by many, including Merritt (1981), Errey (1981) and Coleman (1976). "Establishing or reestablishing optimal preventive measures should remain a primary and basic principle of management.…”

“…. Careful attention to all details of the patient's care will greatly decrease the appearance of complications which could precipitate or enhance spasticity" (Coleman, 1976). These complications include skin ulcers, bladder or bowel distention, and bladder infections.…”

“…This is accomplished through surgical division of the nerve root. The posterior rhizotomy was first introduced by Forester in 1911, but it failed to provide adequate and lasting relief of spasticity (Coleman, 1976). The method of anterior rhizotomy was subsequently developed.…”

“…. Spasticity, the heightened reflex activity ofan isolated spinal cord, is one ofthe most incapacitating complications to the rehabilitation of paraplegics and quadriplegics" (Coleman, 1976).…”