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Patrick Mertens, Professor of Neurosurgery Hôpital Neurologique et Neuro-Chirurgical Pierre Wertheimer, Lyon, France,
Marc Sindou, Professor of Neurosurgery Hôpital Neurologique et Neuro-Chirurgical Pierre Wertheimer, Lyon, France
Spasticity is one of the commonest sequelae of neurological diseases. In most patients spasticity is useful in compensating for lost motor strength. Nevertheless, in a significant number of patients it may become excessive and harmful, leading to further functional losses. Stimulation of spinal cord was developed in the 1970s on the basis of the 'gate-control theory' of Melzach and Wall for the treatment of neurogenic pain. This method has been found to be partially effective in the treatment of spastic syndromes, such as those encountered in multiple sclerosis or spinal cord degenerative diseases, such as Strumpell-Lorrain syndrome. Orthopaedic procedures can reduce spasticity by means of muscle relaxation that results from tendon lengthening and may help in restoring articular function when deformities have become irreducible. Current techniques for correcting excessive shortness of the muscle tendon assembly are muscular desinsertion, myotomy, tenotomy and lengthening tenotomy.
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