After a spinal cord injury, involuntary contractions of the muscles of the legs, trunk, and arms can occur, often made worse by a “noxious” stimulus to the body such as a full bladder, bowel program, skin sore, or urinary tract infection. Spasticity is most commonly treated with oral medications. If spasticity is becomes severe and poorly controlled with medications, then surgical options are available to treat spasticity:
Intrathecal baclofen pump
A pump storing the anti-spasticity medication “baclofen” is placed in the fatty tissues in the abdominal region and delivers the medication to the spinal fluid space around the spinal cord. The baclofen is delivered to the spinal fluid space from the pump by way of a small catheter most commonly threaded through the spine in the lumbar region.
Selective Sensory Micro-Rootlet Section
In patients in whom the baclofen pump may not be effective or who wish to not have a medical device implanted, a surgery directed to portions of the sensory nerve rootlets entering the spinal cord associated with the muscles having spasticity issues can be performed.
Spinal Cord Untethering with Expansion Duraplasty/possible Syrinx (cyst) Shunting
If severe spasticity refractory to medications develops along with other progressive symptoms of posttraumatic spinal cord tethering/syringomyelia, then surgery to treat spinal cord tethering and syringomyelia may be the best first option.