Treatment of spasticity in spinal cord injury with botulinum toxin

The Journal of Spinal Cord Medicine, 2019 · DOI: 10.1080/10790268.2018.1479053 · Published: May 1, 2019

Spinal Cord Injury Pharmacology Neurology

Simple Explanation

Spasticity, a common complication after spinal cord injury (SCI), is often treated with oral medications. This study explores the use of Botulinum toxin (BT) injections as a treatment option for spasticity in SCI patients. The study retrospectively reviews the outcomes of BT injections in SCI patients, focusing on improvements in muscle tone, joint movement, and pain relief. The findings suggest that BT injections can be an effective treatment for focal spasticity (spasticity affecting specific muscle groups) and can complement oral medications for generalized spasticity.

Study Duration

Minimum of 1 year follow-up

Participants

90 patients, predominantly male with incomplete injuries

Evidence Level

Not specified

Key Findings

1
Patients with focal spasticity experienced a significantly greater improvement in muscle tone compared to those with generalized spasticity.
2
Earlier administration of BT injections (within the first 6 months of clinical course) resulted in greater improvements in joint movement and pain relief.
3
Patients with ASIA D injuries (incomplete spinal cord injuries) showed a greater improvement in muscle tone and maintained the effects of the injections for a longer duration.

Research Summary

This retrospective study evaluated the effectiveness of botulinum toxin (BT) injections in treating spasticity in 90 patients with spinal cord injury (SCI). The results indicated that BT injections improved muscle tone, joint movement, and pain, particularly in patients with focal spasticity and incomplete SCI. The study concludes that BT can be a valuable treatment option for focal spasticity in SCI and a useful adjunct to oral medications for generalized spasticity.

Practical Implications

Clinical Practice

Consider botulinum toxin injections as a treatment option for focal spasticity in SCI patients, especially those with incomplete injuries.

Treatment Timing

Administer botulinum toxin injections as early as possible (within the first 6 months of clinical course) to maximize improvements in joint movement and pain relief.

Personalized Treatment

Tailor the treatment approach based on the type and distribution of spasticity, with focal spasticity showing the most significant benefits from botulinum toxin injections.

Study Limitations

1
The study is purely descriptive and lacks a comparison group.
2
Selection bias may be present due to the study being conducted at a specialist SCI rehabilitation center.
3
Geographic dispersion of patients limited complete follow-up for all participants.

Your Feedback

Was this summary helpful?

Back to Spinal Cord Injury