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RETRACTED ARTICLE: Surgical management of intractable spasticity

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European Spine Journal Aims and scope Submit manuscript

This article was retracted on 19 April 2016

Abstract

Background

Spasticity is motor disorder characterized by a velocity-dependent increase in tonic stretch reflexes (muscle tone) with exaggerated tendon jerks, resulting from hyper-excitability of the stretch reflex, as one component of the upper motor neuron syndrome.

Purpose

This study aimed at comparing between spinally based (dorsal rhizotomy) versus peripherally based (selective neurotomy) surgical procedures in management of hypertonia in the lower limbs of pediatrics.

Methods

Over a 3-year period, 50 children with intractable, lower limb spasticity were prospectively treated by selective neurotomy (group A, 35 patients) and dorsal rhizotomy (group B, 15 patients) with 6 months’ follow-up period.

Results

The operative duration was longer with dorsal rhizotomy with mean of 292.2 min versus 76.8 min with neurotomy (P = 0.001) and the hospital stay of dorsal rhizotomy was longer with mean of 6.2 days versus 1.7 days with neurotomy (P = 0.001). Muscles power exhibited significant improvement in 53.3 % of the total rhizotomies (P = 0.001). Following neurotomies; muscle tone showed marked improvement in 69.3 % muscles which had normal tone and 31.9 % of muscles had mild spasticity (P = 0.001). The H/M ratio following dorsal rhizotomies showed marked reduction of the ratio, and the mean was 0.11 versus 0.58 preoperatively.

Conclusion

Both neurotomies and dorsal rhizotomies were safe surgical procedures and were provided with good improvement in respect of: muscle power, severity of spasticity, patient’s ambulation, gait, range of joint movement, associated pain, functional disability, and nerve excitability with no significant difference between both procedures.

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Abbreviations

H/M ratio:

H-reflex/M-response

UMNL:

Upper motor neuron lesion

MRCs:

Medical Research Council scale

DREZ:

Dorsal root entry zone

CBC:

Complete blood picture

CT:

Computerized tomography

MRI:

Magnetic Resonance Image

SPN:

Selective peripheral neurotomy

ITB:

Intrathecal baclofen therapy

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Authors and Affiliations

  1. Neurosurgery Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt

    Mohamed I. Barakat, Waleed Elhady, Mohamed Gouda, Mahmoud Taha & Ibrahim Metwaly

Authors
  1. Mohamed I. Barakat
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  2. Waleed Elhady
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  3. Mohamed Gouda
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  4. Mahmoud Taha
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  5. Ibrahim Metwaly
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Corresponding author

Correspondence to Mohamed I. Barakat.

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Additional information

This article, ‘Surgical management of intractable spasticity’, Mohamed I. Barakat, Waleed Elhady, Mohamed Gouda, Mahmoud Taha and Ibrahim Metwaly published in European Spine Journal, March 2016, Vol. 25, Issue 3, pp 928-935, First online: 14 December 2015, DOI 10.1007/s00586-015-4326-y, has been retracted at the request of the Editor-in-Chief because this article has considerable overlap with the paper published in the Zagazeg University Journal, Egypt, ISSN 1110-1431, in 10-9-2012. Therefore it does not represent entirely original material and has to be withdrawn. The authors have agreed to retract the article, recognizing that it constitutes duplicate publication. In addition Mohamed Gouda asked to remove his name from the paper as a co-author because he had no direct or indirect relations with this paper.

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Barakat, M.I., Elhady, W., Gouda, M. et al. RETRACTED ARTICLE: Surgical management of intractable spasticity. Eur Spine J 25, 928–935 (2016). https://doi.org/10.1007/s00586-015-4326-y

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  • DOI: https://doi.org/10.1007/s00586-015-4326-y

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