Enslin J M N
Division of Neurosurgery, Groote Schuur Hospital, University of Cape Town, Observatory, Cape Town, South Africa.
Red Cross War Memorial Children's Hospital, Rondebosch, Cape Town, South Africa.
Adv Tech Stand Neurosurg. 2025;51:245-254. doi: 10.1007/978-3-031-86441-4_18.
We still base spasticity management on rehabilitation and lesional surgical procedures. These techniques have been well-studied, and long-term follow-up data is available. However, we can still not treat the cause of the spasticity with any of these modalities, and advances in neuromodulation and genetic therapies are promising this in the future. In this chapter, the author describes the new developments in spasticity surgery. The focus is on advances in lesioning techniques, neuromodulation strategies-cerebral, spinal, and peripheral techniques-and genetic and stem cell research. There is still no conclusive evidence showing better outcomes and improved long-term data than our current medication and lesion-based approach, but as the technology improves, this may change. We hope to reach a point where we aim to care for patients with spasticity at the individual cause of each person's spasticity and cure them.
我们仍然将痉挛的治疗基于康复和损伤性外科手术。这些技术已经得到了充分研究,并且有长期随访数据。然而,我们仍然无法通过这些方法中的任何一种来治疗痉挛的病因,而神经调节和基因治疗的进展有望在未来实现这一点。在本章中,作者描述了痉挛手术的新进展。重点是损伤技术、神经调节策略(包括大脑、脊髓和外周技术)以及基因和干细胞研究方面的进展。仍然没有确凿证据表明这些方法能比我们目前基于药物和损伤的方法产生更好的结果并改善长期数据,但随着技术的进步,这种情况可能会改变。我们希望达到这样一个阶段,即我们能够根据每个人痉挛的具体病因来照顾痉挛患者并治愈他们。