This slide illustrates the procedure. The dorsal roots of L2 to S2 are exposed. Rootlets are teased out with a nerve hook and then stimulated individually. If there is an abnormal EMG or muscle activity, the nerve rootlet is cut. In most instances, 25% to 40% of all rootlets are cut. The procedure may produce temporary, and occasionally complete, anesthesia or dysesthesias.

In aggressive procedures, in which 60% of the rootlets are sectioned, severe sensory loss can occur. In most instances, the patient is very weak for the first several weeks or months following the procedure with a resultant decreased function. However, strength does recover to a presurgery level. Infection, weakness, and scoliosis can all complicate the procedure.

Chambers HG. The surgical treatment of spasticity. Muscle Nerve 1997;20(suppl 6):S121-8.