Table 2Summary of included studies

StudyDesignParticipantsComparisonsOutcomes
Albright 1991 Randomised cross-over trial

N=7, age 15 to 31 years (median 18 years), with CP and moderate or severe spastic quadriplegia.

USA

Bolus ITB injection versus baseline and other ITB doses
  • Tone
(follow up 8 hours)
Bertelli 2003 Before & after study

N=7, age 16 to 20 years (median 19 years), with hemiplegic CP and moderate or severe spasticity.

Brazil

Brachial plexus dorsal rhizotomy: pre versus post-operative
  • Gross motor function
  • Tone
(follow up 15 months)
Gerszten 1997 Before & after study

N=24 (21 with CP, 3 with TBI), age 9 to 30 years (mean 18 years), with moderate or severe spasticity.

USA

Continuous ITB infusion: pre versus post-operative
  • Walking
  • Adverse events
(mean follow-up 4.3 years)
Meythaler 2001 Before & after study

N=13, age 13 to 43 years (mean 25 years), with CP, intractable spastic hypertonia and quadriparesis.

USA

Continuous ITB infusion: pre versus post-operative
  • Tone
  • Adverse events
(follow up one year)
Motta 2011 Before & after study

N=9, age 18 or older (mean 23 years) and CP.

Italy

Continuous ITB infusion: pre versus post-operative
  • Gross motor function
(follow up one year)
Reynolds 2011 Before & after study

N=21, age 18 to 36 years (mean 26 years), with CP spastic diplegia, with independent ambulation

USA.

Selective dorsal rhizotomy: pre versus post-operative
  • Walking
  • Gross motor function
  • Tone
  • Health related quality of life
  • Pain
(follow up 4 months – for objective physical assessment; mean 5 years for function self-assessment)
Tasseel Ponche 2010 Before & after study

N=25, mean age 30 years, with CP and moderate or severe spasticity.

France

Continuous ITB infusion: pre versus post-operative
  • Tone
  • Adverse events
(follow up – up to 5 years)
Van Schaeybroeck 2000 Randomised cross-over trial and before & after study

N=11, age 8 to 55 years (median 22 years), with CP and spasticity.

Belgium
  • Bolus ITB injection versus placebo, baseline and other ITB doses
  • Continuous ITB infusion: standard dose versus baseline and reduced dose
  • Tone
  • Adverse events
(follow up 1 year)

CP: cerebral palsy; ITB: intrathecal baclofen; N: number of participants in study; TBI: traumatic brain injury.

From: Management of abnormal muscle tone: neurosurgical procedures to reduce spasticity

Cover of Management of abnormal muscle tone: neurosurgical procedures to reduce spasticity
Management of abnormal muscle tone: neurosurgical procedures to reduce spasticity: Cerebral palsy in adults: Evidence review A2.
NICE Guideline, No. 119.
National Guideline Alliance (UK).
Copyright © NICE 2019.

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