The Bischof Paramedian Longitudinal Mielotomy was applied for treatment of severe spasticity in refractory cases and with secondary sequelae. The technique shows a prolonged improvement in spasticity, with frequent sphincter involvement.
Dr. Bernardo de Monaco has applied modified technique of Bischof's Myelotomy using radiofrequency. The selection of cases is very specific, and an evaluation with a functional neurosurgeon with experience in the treatment of spasticity is suggested. The two main techniques used with adaptation to radiofrequency are: Bischof type 2 and Pourpre (cross myelotomy).This procedure is reserved for severe patients, without preserved functions.