末梢神経縮小術，バクロフェン髄腔内投与療法

Neurosurgery for Spasticity

Point

・痙縮の病態を理解し，症状を見逃さず適切な時期に治療に結びつけることが重要である．

・選択的末梢神経縮小術（SPN）の適応には，痙縮罹患筋肉と神経支配を理解することが重要である．

・バクロフェン髄腔内投与（ITB）療法は調節性に優れた治療法であり，さまざまな疾患や病態に適応ができることを理解する．

　The sequelae of neurosurgical diseases are an increasingly important component of neurologists' clinical practice. Moreover, spasticity is one of the most common of these effects. While spasticity may be useful in compensating for a loss in motor strength, it frequently becomes harmful and leads to further functional losses. When patients with harmful spasticity cannot be managed through physical therapy, neurosurgical treatment must be considered. We present the current state of knowledge relating to the assessment and treatment of spasticity, especially selective peripheral neurotomy and intrathecal baclofen therapy.

　To continue developing therapies for spasticity, we must be familiar with the characteristics of various treatment methods used to treat spasticity and create frameworks for regional alliances that focus primarily on education and rehabilitation programs targeting spasticity treatment that involve patients, patients' families, and medical staff.