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Radiosurgical Irradiation of Spinal Nerve Roots for the Management of Spasticity: A Systematic Review.

Overview

Authors: Muhammad Izhar1, Yusuke S. Hori1, Ahed H. Kattaa1, David J. Park1, Steven D. Chang1
ORCID iDs: Yusuke S. Hori, David J. Park
  1. Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA, USA
Institutions: Stanford Medicine (United States); Stanford University (United States)
Journal: Stereotactic and functional neurosurgery, pages 1-12
Dates: received 23 December 2025; accepted 23 March 2026; published online 30 March 2026; in print March 2026
Type: Other · Language: English
License: CC BY-NC
Identifiers: DOI 10.1159/000551781 · PMID 41911102 · PMCID PMC13241075 · OpenAlex W7143481585
Open access: hybrid, a free copy (OpenAlex)
Status: data only (how the code is found and verified)
Categories: human (organism), other condition (population), clinical / translational (subfield)
Keywords: Radiosurgery, Selective dorsal rhizotomy, Intrathecal baclofen pump, Spasticity, CyberKnife, Gamma knife, Trauma, Cerebral palsy
Journal subjects: Clinical Study
Topic: Botulinum Toxin and Related Neurological Disorders (Clinical Neurology, Medicine), according to OpenAlex
Citations: not cited yet (Europe PMC); 51 references in the paper

Abstract

Introduction: Spasticity is a common and debilitating sensorimotor disorder resulting from injury to the brain or spinal cord. Conventional treatments, including oral antispasmodic agents, botulinum injections, intrathecal baclofen (ITB) pumps, and selective dorsal rhizotomy, are often limited by side effects, invasiveness, and/or inconsistent outcomes. Stereotactic radiosurgery (SRS), a noninvasive image-guided technique traditionally used in oncology and functional neurosurgery, could emerge as a promising alternative for refractory spasticity. The objective of the manuscript was to review the clinical application, safety, and preliminary efficacy of SRS in managing spasticity.

Methods: A systematic literature search was conducted following PRISMA guidelines. Studies were included if they reported spasticity as a primary condition and used SRS as a therapeutic modality. Data on patient characteristics, treatment parameters, outcomes, including Modified Ashworth Scale (MAS) scores and Visual Analog Scale (VAS) pain scores, and adverse events were extracted and analyzed.

Results: Three clinical studies involving a total of 7 patients were identified. SRS was delivered to the affected spinal nerve roots at a prescription dose ranging from 45 to 60 Gy. Mean MAS scores improved from 3.66 to 1.5, and mean VAS pain scores decreased from 7.33 to 1.6 over 24 months of follow-up. No major adverse events were reported. Transient side effects, such as reduced trunk control, occurred in 1 patient. Treatment response varied in onset and duration across cases.

Conclusion: Early evidence suggests that SRS is a feasible approach for the management of spasticity. However, larger prospective studies with longer follow-up are warranted to determine optimal patient selection, dose parameters, and long-term outcomes, including quality of life and potential radiation-related effects.

Reproduced under the paper's license (CC BY-NC), from the paper cited above.

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Data

Datasets cited

Data Availability Statement

No new datasets were generated during this study. All data analyzed in this review paper were obtained from published articles. The extracted data supporting the findings of this study are available from the corresponding author upon reasonable request.

Reproduced under the paper's license (CC BY-NC), from the paper cited above.

Versions

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Version 1, 30 September 2026: the first record

Recorded: type, language, journal, pages, dates, 5 authors, 8 keywords, 50 references.

Cite

This paper

Izhar, M., Hori, Y. S., Kattaa, A. H., Park, D. J., & Chang, S. D. (2026). Radiosurgical Irradiation of Spinal Nerve Roots for the Management of Spasticity: A Systematic Review. Stereotactic and functional neurosurgery, 1-12. https://doi.org/10.1159/000551781

BibTeX

@article{izhar2026radiosurgical,
author = {Izhar, Muhammad and Hori, Yusuke S. and Kattaa, Ahed H. and Park, David J. and Chang, Steven D.},
title = {{Radiosurgical Irradiation of Spinal Nerve Roots for the Management of Spasticity: A Systematic Review}},
journal = {Stereotactic and functional neurosurgery},
year = {2026},
month = mar,
pages = {1--12},
publisher = {Karger Publishers},
issn = {1011-6125},
doi = {10.1159/000551781},
url = {https://doi.org/10.1159/000551781},
pmid = {41911102},
pmcid = {PMC13241075}
}

RIS

TY - JOUR
AU - Izhar, Muhammad
AU - Hori, Yusuke S.
AU - Kattaa, Ahed H.
AU - Park, David J.
AU - Chang, Steven D.
TI - Radiosurgical Irradiation of Spinal Nerve Roots for the Management of Spasticity: A Systematic Review
T2 - Stereotactic and functional neurosurgery
J2 - Stereotact Funct Neurosurg
PY - 2026
DA - 2026/03/30
SP - 1
EP - 12
SN - 1011-6125
PB - Karger Publishers
DO - 10.1159/000551781
UR - https://doi.org/10.1159/000551781
LA - en
ER -

CSL-JSON

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