This book covers evaluation and decision-making in spasticity cases detailing Intrathecal Baclofen Therapy (ITB), Botulinum toxin therapy and surgical methods. Includes procedures on peripheral nerves, dorsal roots, dorsal root entry zone and spinal cord.

Introduction.- General Information: History of neurosurgical treatment for spasticity.- Anatomical and physiological bases of motricity applied to the study of spasticity.- Adults: Evaluation of spasticity in adults.- Decision-making for treatment of adults with disabling spasticity.- Intrathecal Baclofen therapy.- Botulinum toxin injections for spasticity.- Peripheral neurotomies.- Surgery in dorsal root entry zone.- Children: Introduction.- Assessment of spasticity in pediatric patients.- Decision-making for treatment of children with disabling spasticity.- Dorsal rhizotomies for children with cerebral palsy. 

The book is devoted to the neurosurgical management of spasticity. Starting with a chapter on the anatomical and physiological foundations of spasticity and a short history of its neurosurgical treatment, it describes the neurosurgical methods currently available. As management differs between adults and children, the book is also structured accordingly, including evaluation, decision-making, Intrathecal Baclofen Therapy (ITB), botulinum toxin therapy, and surgery. Beyond ITB, the neurosurgical options covered include procedures focusing on the peripheral nerves, dorsal roots, Dorsal Root Entry Zone and spinal cord.Based on surgical experience collected with more than a thousand patients, the book gathers the most important aspects of our present understanding, presented using a practical, educational approach. It stresses the importance of a multidisciplinary approach, including neurologists, pediatricians and rehabilitation specialists. Close collaboration with other surgical disciplines like orthopedic surgery and neuro-urology are also outlined.

“It outlines the fundamentals of pathophysiology to presentations and therapeutic options, and the various neurosurgical techniques. The audience includes pediatric and adult neurosurgeons, neurologists, orthopedists, pediatricians, and physical medicine and rehabilitation physicians, both practicing and in training. It is appropriate for physical and occupational therapists and rehabilitation teams. … This is an excellent guide to spasticity in patients of all ages, and it represents the lifetime experience of legends in the field. The book is great contribution to the field.” (Ramsis Farid Ghaly, Doody's Book Reviews, April, 2015)

Presenting knowledge most relevant to present-day neurosurgical management of disabling spasticity Clinical observations, gained in the treatment of more than a thousand patients An appendix contains scales, schematic drawings and forms that can be used in dealing with patients