ABSTRACT
Spasticity arises from a variety of neurologic disorders, including cerebral palsy, multiple sclerosis, cerebrovascular accidents, spinal cord injury, and head trauma.
Selective posterior rhizotomy is now an accepted procedure for relieving spasticity in carefully selected patients with spastic cerebral palsy (CP). Recent developments in electrophysiologic monitoring and refinements in surgical technique have led to a resurgence in the use of this procedure for patients with spastic cerebral palsy [1-7]. Dorsal rhizotomy is performed through bilateral L2 to S1 laminectomies or laminotomies to allow selective division of lumbosacral posterior spinal rootlets with electromyographic (EMG) guidance. In patients with cerebral palsy, judicious patient selection, intraoperative monitoring, and intensive postoperative physical and occupational therapy are essential for successful surgical outcome [1,8]. Ambulatory patients with spastic diplegia and those with pure spasticity without motor weakness or severe contractures show the greatest functional improvement [1,8,9].
