Questions
When a brain injury occurs, either due to childbirth such as lack of oxygen or even before it due to other conditions such as hypoxia or suffocation, as well as from injuries that may be a traffic accident, it implies that part of the brain suffers a necrosis, that is, part of the brain is left dead and instead appears as a kind of callus or destruction with lack of tissue which is what causes the rest body suffers from abnormalities. These anomalies are what we know as spasticity.
Spasticity causes stiffness of the body, both in its members and elsewhere, for example the face. In short, the injury is in the brain but the symptoms are in the body. Therefore it is the symptoms that are operable. Brain injury won’t increase or decrease, it’s just there.
In which the patient already has myofascial retractions in his body.
Normally, in children from the age of 2 and a half.
After those 30 minutes, the patient goes to an observation period as in any other type of operation. After this short period of time, the post-operative 24 hours in the clinic will be followed, accompanied at all times by health personnel.
Once the impediment to the muscle is cut, it regains its functionality. It is clear that a muscle not worked for many years has symptoms of weakness. The muscle must be stimulated to fulfill its function. The way to do this is through physical exercise and different types of rehabilitation.
Physical therapy is within the concept of rehabilitation and will be indicated by doctors and may be complementary to that performed through the patient’s usual physical therapist (e.g. intensive therapies).
The experience with those affected in Spain is more than 8 years, having not been aware of cases that have receded since their initial state, if not quite the opposite. What can be noted is that initially, after the operation, you can experience a slight recoil of the patient.
This is because although the operations do not present external wounds, internally there is a small trauma arising from the cutting of the fiber. Although it is light, it should not be forgotten that by operation up to 24 points are treated, that is, up to 24 fibers are cut. This means that the patient must keep a rest time, in which he logically will not perform some activities that he did before, until after that time.
After initial operations, the patient’s evolution should be observed. New contractures may be manifested, though not in the same place. This is because the major and most invalidating contractures are the ones that are treated. Once these are missing, other minors may manifest themselves that already existed.
In any case, at the end of the patient’s body development is when one more operation has to be evaluated. The fact of improving the quality of life in childhood and adolescence should be assessed accordingly, not depriving them during those years of the benefits provided by this technique, including that skeletal deformations, dislocations, hard-to-treat joint retractions do not occur or aggravate.
It depends on the degree of involvement of each patient. Severely affected may require at least three operations. Others with one is enough. The same muscle is operated only once. After cutting the stiffness of it, it does not re-produce and there is no chance that this small, dead, stiff muscle portion will rejoin.
It depends on the degree of involvement of each patient. Severely affected may require at least three operations. Others with one is enough. The same muscle is operated only once. After cutting the stiffness of it, it does not re-produce and there is no chance that this small, dead, stiff muscle portion will rejoin.
A point of pain is what causes the affected person to adopt those twisting postures that we all see. If a child twists his or her legs or arms and is always in that posture, it is because that is why he is unconsciously protected from the pain that would cause that limb to be straight, in his normal position. Retraction and stiffness mean they can’t have an extended limb normally because that causes them pain. They don’t complain, they don’t cry, because they take the anomalous stance to defend themselves against it.
However, by tapping on the point of pain appropriately by the specialist, you can see in the child a gesture of pain because that is where exactly it hurts. Those affected defend themselves against this by writhing or shrinking. Over the years, these positions affect the entire member(s) concerned, also resulting in squeletic malformations, more or less severe depending on the cases of involvement.
No. Anyone with myofascial retractions can be operated on. Logically, the smaller the affected one, complications arising from his ailment, especially the skeletal ones referred to above, could be avoided. It should not be forgotten that even not achieving a total improvement in the most affected cases, the improvement in the quality of life, both of the affected and of the relatives, is very important.
No. The only thing that will happen is that the free muscle of its retraction will need to be gradually strengthened. That’s what physical therapy and rehabilitation are for.
The number of operations depends on the degree of patient involvement. In very pronounced degrees, almost always three or even some more are needed. Others, less affected, get the results in a single operation, such as those with an affected foot or side. Obviously that will be valued by the doctor.
Enough time for the patient’s recovery and to observe the advances and evolution that occur in it.
Generally, from 8-10 months a second phase can be performed.
There have been cases of children taking myorelajantes (lioresal or baclofen) and the operation reduced spasticity and stiffness. In such cases of withdrawing the medication should be at the doctor’s direction and reducing the doses gradually, never at once. Consult with each other’s doctor how to suppress the medication.
Over time the retractions will affect the miofascial system to a greater extent, cause problems
even more severe, such as joint contractures up to ankylosis, dislocations, dysmetry, deformities
bone, etc.
The first results are seen in some patients the next day, others within a month and can be demonstrated during the next postoperative months (but the main ones are demonstrated over the first 3 months).