Myelotomy for control of mass spasms in paraplegia

Abstract

A new myelotomy knife was described and a procedure, designed to sever certain reflex connections while preserving as many corticospinal connections as possible, was presented. Through intermittent dorsal midline incisions the gray matter lateral to the central canal was severed bilaterally under the microscope from L-1 to S-1. This procedure relieved mass spasms and hyperactive reflexes in 14 paraplegic or tetraplegic patients, but preserved postural reflexes and whatever voluntary motor power the patients had prior to myelotomy. Before myelotomy all patients were bedridden. Afterward 9 patients were able to use a wheel chair and 5 were able to walk with the use of parallel bars or crutches.