What type of anesthesia is performed?
Regional anesthesia is usually performed: the nerves are anesthetized at the level of the axilla. But it is not possible in some cases: young children, sugery of the shoulder, patient with abnormal movements or severe anxiety… In these cases, a general anesthesia is performed.
How long is the hospital stay?
In most cases it is possible to leave the hospital the same day after surgery. Sometimes the condition of the patient requires post-operative monitoring for one extra day.
Does it hurt… ?
Surgery would hurt if we didn’t have powerful medications to eliminate the pain. Regional anesthesia provides pain relief for up to 24 hours, depending on the type of drug administered, then oral pain medications are utilized until the pain disappears. It is important to treat the pain as soon as it manifests.
Is a cast / splint necessary after surgery?
It depends on the type of surgery. In some cases (selective neurectomy, fractional tendon lengthening), no immobilization is required. In others (tendon transfer, Z tendon lengthening), a cast is necessary for one month. Afterwards, a night splint is often recommended for several months.
What are the potential complications of surgery?
Every surgery, no matter how small, may lead to (induce) complications. However, complications are rare after this type of surgery. General complications of surgery include mainly hematoma (especially in patients receiving anti-blood clotting medications), unsightly skin scars, infection. Potential complications of the techniques described above include insufficient release of a contracted muscle, insufficient diminution of spasticity, and in the long term recurrence of spasticity or contracture, all of which may require a secondary surgery. This list is not exhaustive, and other extremely rare complications can also occur.
Does every spastic patient need surgery?
No, surgery is indicated only in selected cases. It can be helpful for improving function, for correcting a deformity, facilitate care and nursing, get rid of pain, and/or improve cosmesis. The decision to perform surgery is made with the whole medical team and the patient, after one or several visits. In some cases, despite severe deficits, surgery will not be able to help, and is not indicated.
