OBJECTIVE: To evaluate the long-term efficacy of spasticity-corrective surgery and botulinum toxin treatment in patients with upper limb spasticity. DESIGN: Pretest-posttest quasi-experimental study. PATIENTS: Thirty-four patients with disabling spasticity. METHODS: Patients were divided into 2 groups based on their treatment preference: the surgery group, which underwent tendon lengthening/release ( RESULTS: The surgery group demonstrated significantly greater reductions in composite Modified Ashworth Scale scores, with a mean change of 2.7 (SD 0.8), compared to the botulinum toxin group (1.1, SD 0.6 at peak
0.3, SD 0.5 at long-term
CONCLUSION: Spasticity-corrective surgery achieves superior and longer-lasting benefits compared to botulinum toxin treatment in patients with disabling upper limb spasticity.