Seventh Cervical Nerve (C7) Transection for Spastic Arm Paralysis After Cerebral Injury

Research methodology: A bibliometric review using the spastic hand as an example

Bibliometric review involves systematically analysing the academic literature on a particular topic, enabling researchers to better understand the trajectory and future trends of a specific research field. This study uses various bibliometric tools to analyse relevant research on the spastic hand over the past two decades, aiming to identify key contributors, hotspots and emerging trends. The results show that early studies focused on cerebral palsy, stroke and botulinum toxin treatment, while recent advancements highlight surgical procedures such as neurectomy and soft tissue transfer. Future research should enhance international collaboration and the use of neuroimaging and electrophysiological techniques to gain a deeper understanding of the neural mechanisms underlying spasticity, optimize surgical procedures and explore novel treatments for spastic hand.

Nerve-Targeted Surgical Treatments for Spasticity: A Narrative Review

Spasticity is a potentially debilitating symptom of various acquired and congenital neurologic pathologies that, without adequate treatment, may lead to long-term disability, compromise functional independence, and negatively impact mental health. Several conservative as well as non-nerve targeted surgical strategies have been developed for the treatment of spasticity, but these may be associated with significant drawbacks, such as adverse side effects to medication, device dependence on intrathecal baclofen pumps, and inadequate relief with tendon-based procedures. In these circumstances, patients may benefit from nerve-targeted surgical interventions such as (i) selective dorsal rhizotomy, (ii) hyperselective neurectomy, and (iii) nerve transfer. When selecting the appropriate surgical approach, preoperative patient characteristics, as well as the risks and benefits of nerve-targeted surgical intervention, must be carefully evaluated. Here, we review the current evidence on the efficacy of these nerve-targeted surgical approaches for treating spasticity across various congenital and acquired neurologic pathologies.