Post Traumatic Induced Spasticity
Conditions
Keywords
Selective dorsal rhizotomy, Spasticity, Post traumatic induced spasticity, Spinal cord injury, Traumatic brain injury
Brief summary
The investigators will investigate the selective dorsal rhizotomy in post traumatic brain and spinal cord injury induced spasticity to evaluate the efficacy of this procedure in reducing the tone of the spastic muscle groups. Selective dorsal rhizotomy is well established effective procedure in participants with cerebral palsy associated spasticity. As low and middle income countries, intrathecal baclofen pump is expensive for patients.
Detailed description
Spasticity is a condition that represents a form of disability and it's associated in various conditions. Intrathecal baclofen pump is tried and has a good outcome in treatment spasticity. However, it has some aide effects and complications and also expensive. Selective dorsal rhizotomy is a surgical procedure that represents an optional treatment for spasticity and established with cerebral palsy and hereditary spasticity. Selective dorsal rhizotomy in participants with Post traumatic induced spasticity isn't established yet and not compared with the results of intrathecal baclofen. SDR is a procedure applied under general anesthesia and with neuromonitoring.
Interventions
PROCEDURESelective dorsal rhizotomy with neuromonitoring
In prone position and Under general anaesthesia, and according to neuromonitoring, a microscopic cut of the rootlet ( of the dorsal root of spinal nerve) that supply the group that is most spastic
Sponsors
Assiut University
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
* Patients who are four year-old and above of both sexes. * Patient with post traumatic head and / or spinal injury-induced spasticity. * Ambulant and non-ambulant patient.
Exclusion criteria
* Patient below age of four year. * Other conditions induced- spasticity e.g. Strokes, CP, MS, Hereditary spastic paresis, ALS, tumors, infections and degenerative diseases. * Patient underwent previous intrathecal baclofen pump administration.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in spasticity severity assessed by the Modified Ashworth Scale (MAS) and electromyography (EMG) amplitude | From one week to six months post operative. | The primary outcome will be the reduction in spasticity, quantified by the change in MAS scores and EMG muscle activity measurements from baseline to post-intervention. The MAS score, ranged from 0 to 4 as 0 represents no increase in muscle tone and 4 indicates rigid limb flexion/extension, will be reported as the mean change in points, and EMG data will be summarized using the mean and standard deviation of muscle activity amplitude during standardized stretch protocols. The data will be analyzed to determine the statistical significance of improvements following the selective dorsal rhizotomy procedure |
Contacts
CONTACTAfnan Morad
Outcome results
None listed