Repeated botulinum toxin injections can improve mobility in patients with spinal cord lesions

A. Catz*, H. Barkol, F. Steinberg, J. Ronen, V. Bluvshtein, O. Keren

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Aim. The aim of this study was to increase the knowledge about the response to botulinum toxin (BTX) injections to spastic leg muscle motor points (MP) in spinal cord lesion (SCL) patients, and describe improvement of mobility with repeated BTX injections. Methods. Six patients with ASIA grade C or D SCL were studied at the Loewenstein Rehabilitation Center, Israel. The main outcome measures were: modified Ashworth scale scores, range of motion (ROM), and mobility spinal cord independence measure (SCIM) scores. BTX was injected twice within a few weeks' interval to the MP of spastic leg muscles. The outcome measures were monitored before each injection and 2 weeks or more after the second injection. Results. Following the first BTX injection the tonus decreased, ROM increased in all 6 patients, and mobility functioning improved in 4 of them. Following the repeated injection the tonus further decreased, ROM further improved in 5 of 6 patients, and mobility functions further improved in 4 of 6 patients. Conclusion. BTX can improve mobility in patients with SCL. Repeated injections may enhance the effect despite the concern for resistance formation. Further research is needed to support the findings and determine the optimal BTX doses and intervals between injections.

Original languageEnglish
Pages (from-to)319-325
Number of pages7
JournalEuropa Medicophysica
Issue number3
StatePublished - Sep 2007


  • Botulinum toxins
  • Muscle spasticity
  • Neuromuscolar block
  • Spinal cord compression


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