Treatment of spasticity by subarachnoid phenolglycerin

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Abstract
The technique used in subarachnoid injection of phenol in glycerin in the treatment of spasticity of the legs is described, and the results obtained by 27 injections in 16 patients are discussed. The treatment is effective and has an average duration of more than 12 months. The relief is associated with damage to the alpha neurons, but complete relaxation does not necessarily entail paralysis. The therapy may lead to impairment of the sphincteric and vesical function, but when high-level lumbar injections are employed, this complication is rare. Furthermore, secondary pain and localized arachnoiditis may develop. The method may be contemplated in incapacitated patients with severe spasticity of the legs, and flexion contractures or spasms, or both. It is unsuited in patients with preserved gait. In our experinence, the injections should be given at high lumbar level and consist of, at the most, 1ml. of a 5% solution of phenol in glycerin.