Children with spasticity receive medical and surgical care in the Spasticity Clinic at Johns Hopkins All Children’s Hospital in St. Petersburg, Florida.

Our Approach to Treatment in the Spasticity Clinic

In the Spasticity Clinic, our providers evaluate children who have spasticity and for whom oral medications and botulinum toxin may no longer be the best course of treatment to determine if an ITB pump or surgical treatment is right for them.

Spasticity is abnormal muscle tightness caused by an imbalance of signals in the central nervous system from the brain and through the spinal cord. It can occur with damage to the brain or spinal cord, and is typically associated with:

• Cerebral palsy (CP)
• Stroke
• Traumatic brain or spinal cord injury

Spasticity may affect a child’s ability to walk, run, perform hygiene or use their arms, and can prevent muscle growth and cause bone deformities. For children with spasticity, oral medications are typically the initial treatment recommendation. Botulinum toxin is also commonly used. While patients may see reduced spasticity with these treatments, for some children additional treatment options may be appropriate.

These treatment options include:

Intrathecal baclofen (ITB) pump: An ITB pump delivers the medication baclofen to a small space around the spinal cord. Baclofen causes the receptors in the spinal cord to relax the affected muscles. The ITB pump is implanted surgically under the skin of the lower abdomen.

Selective dorsal rhizotomy (SDR): This is a surgical procedure to treat spasticity. A small incision is made in the patient’s lower back to cut some of the nerves that are sending abnormal signals to the leg muscles, which can reduce spasticity in the legs. Learn more about selective dorsal rhizotomy.

Our multidisciplinary team includes specialists in pediatric rehabilitation medicine and neurosurgery. Our team will review your child’s medical history with you and your child will have a physical exam to evaluate the extent of their spasticity.

After surgery and discharge from the hospital, your child will receive follow up care from our team, as well as rehabilitation services, such as occupational and physical therapy, to meet their individual needs.