Possibilities of applying the method of radiofrequency (RF)thermal destruction to correct spasticity in childrenwith cerebral palsy

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Abstract

For the treatment of focal spasticity in the TurnerInstitute we developed and applied the approach toreduce spasticity in children with cerebral palsy byapplying the method of radiofrequency thermal de-struction of peripheral nerves and muscle motorpoints. This method is based on the effect of heatrelease during the passage through biological tissueof radiofrequency currents. The procedure was totally performed in 112 patients aged 1,2 to 14 yearsold with a level of spasticity over 3 points on a scaleAshworth. In order to reduce hypertonia of femuradductors, the target for RF ablation was obturatornerve; we targeted on the motor point of the gastrocnemius muscle in equinus, to reduce forearm flexorhypertonia we targeted on the musculo-cutaneousnerve, flexor muscles of the hand we intervened on their motor points. A positive result was maintained at follow-up of 6 months to one year in all patients, maximum - 2 years. The obtained results are preliminary and subject to further statistical processing, but they are quite comparable with the results of the use of type A botulinum toxin preparations. The proposed method of treatment is minimally invasive, virtually devoid of the risk of postoperative complications, can cut one stage spasticity in the muscles of various motor segments in children with cerebral palsy of great age range, including children up to 2 years old.

About the authors

Alexey Vasilievich Zvozil

The Turner Institute for Children’s Orthopedics, Saint-Petersburg

Email: zvosil@mail.ru
MD, PhD, senior research associate of the department of infantile cerebral palsy. FSBI “Scientific and Research Institute for Children’s Orthopedics n. a. G. I. Turner” under the Ministr y of Health of the Russian Federation

Valery Vladimirovich Umnov

The Turner Institute for Children’s Orthopedics, Saint-Petersburg

Email: umnovvv@gmail.com
MD, PhD, professor, head of the department of infantile cerebral palsy. FSBI “Scientific and Research Institute for Children’s Orthopedics n. a. G. I. Turner” under the Ministry of Health of the Russian Federation

Vladimir Aleksandrovich Novikov

The Turner Institute for Children’s Orthopedics, Saint-Petersburg

MD, research associate of the department of infantile cerebral palsy. FSBI “Scientific and Research Institute for Children’s Orthopedics n. a. G. I. Turner” under the Ministry of Health of the Russian Federation

Dmitry Valerievi Umnov

The Turner Institute for Children’s Orthopedics, Saint-Petersburg

MD, PhD, research associate of the department of infantile cerebral palsy. FSBI “Scientific and Research Institute for Children’s Orthopedics n. a. G. I. Turner” under the Ministry of Health of the Russian Federation

References

  1. Бадалян Л.О. Детская неврология. М.: Медицина,1984;576.
  2. Гончарова М.Н., Гринина А.В., Мирзоева И.И. Реабилитация детей с заболеваниями и повреждениями опорно-двигательного аппарата. Л.: Медицина,1974;208.
  3. Лобов М.А., Белоусова Е.Д., Шаховская Н.И., Малиновская О.Н. Ботокс в лечение детского церебрального паралича // Вестник практической неврологии. 2001;(6):8.
  4. Никитина Н.М. Детский церебральный паралич.М.: Медицина, 1979;116.
  5. Орлова О.Р. Применение ботокса (токсина ботулизма типа А) в клинической практике: Руководство для врачей. М.: Каталог, 2001;208.
  6. Abbruzzese G. The medical management of spasticity. // European Journal of Neurology. 2002;9(1):30-34.
  7. Carr L.J., et al. Position paper on the use of botulinum toxin in cerebral palsy. // Arch Dis Child. 1998;(79):271-273.
  8. Chen S. Ultrastructural study on the peripheral nerve and skeletal muscle of patients with spastic cerebral palsy. // Zhonghua Wai Ke Za Zhi. 2000;38(8):613-616
  9. Gracies J.M., Nance P. Traditional pharmacological treatment of spasticity. Part I: Local treatments. // Muscle Nerve. 1997;20:S61-S91.
  10. Kanpolat Y., Cağlar C., Akiş E., Ertürk A., Uluğ H. Percutaneous selective RF neurotomy in spasticity. // Acta Neurochir Suppl (Wien). 1987;39:96-8.
  11. Kanpolat Y., Savas A., Bekar A., Berk C. Percutaneous controlled radiofrequency trigeminal rhizotomy for the treatment of idiopathic trigeminal neuralgia: 25-year experience with 1,600 patients. // Neurosurgery. 2001;48:524-532.
  12. Moore J. Handbook of botulinum toxin treatment. Oxford: Blackwell Scientific Publications, 1995. 289 p.
  13. Pua B.B., Thornton R.H., Solomon S.B. Radiofrequency ablation: treatment of primary lung cancer. // Semin Roentgenol. 2011 Jul;46(3):224-9.
  14. Lee S., Oh J., Jung Y. Percutaneous Selective Radiofrequency Thermocqagulathion in the Treatment of Spastic Cerebral Palsy. // J Korean Acad Reabil Med. 2008 Jun;32(3):340-344.
  15. Lee S., Oh J., Jung Y., Choi K. Selective Radiofrequency Thermocqagulathion in the Treatment of Spasticity with Cerebral Palsy. // J Korean Acad Reabil Med. 2009 Apr.; 33(2):198-204.
  16. Smail D.B. Clinical evaluation of spasticity. // Neurochirurgie. 2003;49(2-3):190-198.
  17. Son J.H., Kim S.D., Kim S.H., Lim D.J., Park J.Y. The efficacy of repeated radiofrequency medial branch neurotomy for lumbar facet syndrome. // J Korean Neurosurg Soc.2010 Sep;48(3):240-3. Epub 2010 Sep 30.

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Copyright (c) 2015 Zvozil A.V., Umnov V.V., Novikov V.A., Umnov D.V.

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