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The book, in its second edition, is devoted to the neurosurgical
management of spasticity and focal dystonia. Starting with a
chapter on the anatomical and physiological bases 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. The
large spectrum of scales for assessing hypertonia, spasticity,
dystonia, contracture and joint/bone deformities, as well as the
scoring systems for quantifying functional abilities are critically
reviewed. Beyond ITB, the neurosurgical options covered include the
microsurgical procedures focusing on the peripheral nerves, dorsal
roots, Dorsal Root Entry Zone and spinal cord, and their
intra-operative monitoring. In this second edition, the orthopedic
surgical interventions available will take a large place, either as
alternative solutions , or even better as important complements
after spasticity be solved by the neurosurgical treatments. Based
on surgical experience collected with more than a thousand and
eight-hundred 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 collaborations with other
surgical disciplines like orthopedic surgery and neuro-urology are
outlined.
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