Which intervention is designed to reduce spasticity by surgically targeting nerve roots?

Which intervention is designed to reduce spasticity by surgically targeting nerve roots?

• A. Selective dorsal rhizotomy
• B. Baclofen pump
• C. Botulinum toxin injections
• D. Distal femoral extension osteotomy

Answer: (A)

Selective dorsal rhizotomy reduces spasticity by surgically severing a portion of the dorsal (sensory) nerve root fibers. By decreasing the afferent input from muscles, it dampens the hyperactive stretch reflex that drives spasticity in the legs, leading to lower tone and easier movement. This approach targets the neural reflex pathways themselves rather than just delivering medication or altering the limb’s structure. Baclofen pumps and botulinum toxin injections reduce spasticity pharmacologically or locally, not by cutting nerve roots, and distal femoral extension osteotomy changes bone alignment to improve function without addressing the neural drive. SDR is particularly used when spasticity significantly impedes movement and there’s potential for functional gains after careful neurosurgical evaluation.

Selective dorsal rhizotomy reduces spasticity by surgically severing a portion of the dorsal (sensory) nerve root fibers. By decreasing the afferent input from muscles, it dampens the hyperactive stretch reflex that drives spasticity in the legs, leading to lower tone and easier movement. This approach targets the neural reflex pathways themselves rather than just delivering medication or altering the limb’s structure. Baclofen pumps and botulinum toxin injections reduce spasticity pharmacologically or locally, not by cutting nerve roots, and distal femoral extension osteotomy changes bone alignment to improve function without addressing the neural drive. SDR is particularly used when spasticity significantly impedes movement and there’s potential for functional gains after careful neurosurgical evaluation.