LONG-TERM FUNCTIONAL RECOVERY FOLLOWING BOTULINUM TOXIN TYPE A FOR GASTROCNEMIUS HYPERTONIA AFTER LUMBAR LAMINECTOMY: A CASE REPORT

Background: Focal muscle hypertonia/spasticity can complicate recovery after spinal surgery,limiting mobility and function. Botulinum toxin type A (BoNTA) reduces acetylcholine release at the neuromuscular junction and is an established, targeted therapy for focal spasticity when combined with rehabilitation.

Case: A 23year old man developed painful spasms and focal hypertonia of the right gastrocnemius after L2 L3 laminectomy. Ultrasound guided BoNTA was administered to the medial (25 U) and lateral (12.5 U) heads, followed by a structured rehabilitation program.

Outcomes: The patient showed rapid improvements in pain, modified Ashworth scale (MAS), ankle dorsiflexion, and gait within two weeks; he resumed light jogging by three months. At two years, he reported full return to running and gym activities without reinjection and no adverse effects.

Conclusion: In this postoperative context of focal gastrocnemius hypertonia, BoNTA plus rehabilitation was associated with sustained pain relief and functional recovery over two years,supporting individualized, multidisciplinary spasticity management.