Abstract
Selective dorsal rootlet rhizotomy (SDRR) permits a more controlled step-wise approach to the treatment of spasticity. This procedure allows one to modulate the afferent input to the spinal cord without affecting the efferent output to the anterior horn cell. SDRR allows for a selection of the motor levels affected by spasticity while preserving others. Reported is a case in which SDRR was performed to improve function and reduce spasticity in a patient with multiple sclerosis. As a result of the procedure, the patient's muscle tone was reduced but not ablated, allowing for self-catheterizations, improved sitting posture, transfers, and a gain of at least one full muscle grade in voluntary motor control of the lower extremities. Selective dorsal rootlet rhizotomy offers an alternative to other more radical surgical procedures in modulating spasticity in multiple sclerosis when medical management is not sufficient.