Perioperative Botulinum Toxin Injections to Enhance Surgical Outcomes in Patients With Spasticity: Preoperative, Intraoperative, and Postoperative Case Reports

Geoffrey Frost; Heather Finlayson; Sepehr Saeidiborojeni; Philippe Lagnau; Rajiv Reebye

doi:10.1016/j.arrct.2021.100101

Perioperative Botulinum Toxin Injections to Enhance Surgical Outcomes in Patients With Spasticity: Preoperative, Intraoperative, and Postoperative Case Reports

Arch Rehabil Res Clin Transl. 2021 Jan 12;3(1):100101. doi: 10.1016/j.arrct.2021.100101. eCollection 2021 Mar.

Authors

Geoffrey Frost¹, Heather Finlayson^{1

2

3}, Sepehr Saeidiborojeni³, Philippe Lagnau^{2

3}, Rajiv Reebye^{1

2

3}

Affiliations

¹ Division of Physical Medicine and Rehabilitation, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia.
² GF Strong Rehabilitation Centre, Vancouver, British Columbia.
³ Canadian Advances for Neuro-orthopedics for Spasticity Congress (CANOSC), Kingston, Ontario, Canada.

Abstract

Spasticity causes an array of disabilities, which in turn may lead to the need for surgical intervention. Spasticity itself may also negatively affect surgical outcomes. This report reviews the potential benefit of perioperative (before, during, or after surgery) botulinum toxin (BoNT) injections for 3 patients with spasticity due to spinal cord injury, stroke, or multiple sclerosis. We discuss perioperative BoNT in 3 time periods: preoperatively, intraoperatively, and postoperatively. The cases demonstrate the use of perioperative BoNT in decreasing pain, improving wound healing, and improving surgical outcomes. We conclude by discussing the potential use of perioperative BoNT for surgical interventions in patients with spasticity and the need for further high-quality research in this field.

Keywords: BoNT, botulinum toxin; Botulinum toxin; CP, cerebral palsy; MS, multiple sclerosis; Perioperative; RCT, randomized controlled trial; Rehabilitation; SCI, spinal cord injury; Spasticity; UMN, upper motor neuron.

Publication types

Case Reports