Central limb spasticity is a common complication after central nervous system injury, in which hand flexion spasticity often leads to the loss of the patient’s ability to move. Reducing muscle tone and relieving spasticity are the prerequisites for restoring limb function. T1 rhizotomy, which has been proposed in recent years, has proven to be effective in the treatment of central hand flexion spasticity. This consensus summarizes the etiology, symptoms, functional assessment of central hand flexion spasticity, and surgical indications for T1 rhizotomy, surgical principles and procedures, and rehabilitation program. The standardized protocol of T1 rhizotomy for the treatment of central hand flexion spasticity is proposed for the reference of clinicians in the process of diagnosis and treatment, with the aim of further improving the treatment level for central hand flexion spasticity.
ObjectiveTo investigate the effectiveness of T1 rhizotomy combined with flexor origin slide for central hand flexion spasticity. Methods Between July 2023 and June 2025, 10 patients with central spastic flexion deformity and concomitant flexor tendon contracture due to traumatic brain injury, cerebral palsy, or other causes were admitted. All patients were treated with T1 rhizotomy combined with flexor origin slide. Postoperative assessments included the Modified Ashworth Scale (MAS) for muscle tone, Medical Research Council (MRC) scale for muscle strength, Fugl-Meyer score for upper extremity motor function, and House Functional Classification (HFC) for hand function. Results All patients successfully completed the operations and were followed up 6-19 months (median, 13 months). During follow-up, patients showed significant relief of hand spasticity and improvement in hand function. At last follow-up, the MAS grade for muscle tone, Fugl-Meyer score for upper extremity motor function, and HFC grade for hand function showed significant improvement compared to preoperative levels (P<0.05); but there was no significant difference in MRC grade for muscle strength or PRWE score between pre- and post-operation (P>0.05). Conclusion T1 rhizotomy combined with flexor origin slide effectively reduces muscle tone, corrects flexion deformity, and improves hand function, representing an effective surgical strategy for central spastic flexion deformity of the hand.