Management of Spasticity

Spasticity has traditionally been considered a disease that can be medically managed with oral agents, botulinum injections, and serial casting. Medical management, while often effective, usually offers transient effects whose efficacy can wane over time with sustained use. In recent decades, surgical and technological advances have enabled the utility of an implanted intrathecal baclofen pump or laminectomy for selective dorsal rhizotomy for the treatment of pediatric spasticity. The surgical indications differ for each procedure. A baclofen pump can treat all types of spastic cerebral palsy while selective dorsal rhizotomy is confined to spastic diplegia in young, high-functioning patients. Each type of surgical intervention has provided patients with improved quality of life and control of their disease.