{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T09:45:58Z","timestamp":1785750358651,"version":"3.56.0"},"reference-count":21,"publisher":"Elsevier BV","issue":"8","license":[{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T00:00:00Z","timestamp":1773014400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","jhandsurg.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Hand Surgery"],"published-print":{"date-parts":[[2026,8]]},"DOI":"10.1016\/j.jhsa.2026.02.023","type":"journal-article","created":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T23:56:03Z","timestamp":1776383763000},"page":"882.e1-882.e8","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparative Cost Analysis of Surgery Versus Neurotoxin Injection for Long-Term Management of Upper-Extremity Spasticity"],"prefix":"10.1016","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-1312-8598","authenticated-orcid":false,"given":"Benjamin","family":"Savitz","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Orlane","family":"Caro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariam","family":"Saad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"O\u2019Neill","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shady","family":"Elmaraghi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"2","key":"10.1016\/j.jhsa.2026.02.023_bib1","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1080\/10790268.2018.1543093","article-title":"Assessment of quality of life in relation to spasticity severity and socio-demographic and clinical factors among patients with spinal cord injury","volume":"43","author":"Vural","year":"2020","journal-title":"J Spinal Cord Med"},{"issue":"11","key":"10.1016\/j.jhsa.2026.02.023_bib2","doi-asserted-by":"crossref","first-page":"973","DOI":"10.1038\/sc.2016.46","article-title":"Pain, spasticity and quality of life in individuals with traumatic spinal cord injury in Denmark","volume":"54","author":"Andresen","year":"2016","journal-title":"Spinal Cord"},{"key":"10.1016\/j.jhsa.2026.02.023_bib3","article-title":"Clinical understanding of spasticity: implications for practice","volume":"2014","author":"Bhimani","year":"2014","journal-title":"Rehabil Res Pract"},{"key":"10.1016\/j.jhsa.2026.02.023_bib4","doi-asserted-by":"crossref","DOI":"10.1155\/2014\/354906","article-title":"Pathophysiology of spasticity: implications for neurorehabilitation","volume":"2014","author":"Trompetto","year":"2014","journal-title":"Biomed Res Int"},{"key":"10.1016\/j.jhsa.2026.02.023_bib5","doi-asserted-by":"crossref","first-page":"104","DOI":"10.3389\/fneur.2020.00104","article-title":"Effectiveness of abobotulinumtoxinA in post-stroke upper limb spasticity in relation to timing of treatment","volume":"11","author":"Wissel","year":"2020","journal-title":"Front Neurol"},{"issue":"5","key":"10.1016\/j.jhsa.2026.02.023_bib6","doi-asserted-by":"crossref","first-page":"1306","DOI":"10.1212\/WNL.46.5.1306","article-title":"Botulinum toxin type A in the treatment of upper extremity spasticity: a randomized, double-blind, placebo-controlled trial","volume":"46","author":"Simpson","year":"1996","journal-title":"Neurology"},{"issue":"5","key":"10.1016\/j.jhsa.2026.02.023_bib7","doi-asserted-by":"crossref","first-page":"1371","DOI":"10.1161\/STROKEAHA.110.582197","article-title":"Botulinum toxin for the upper limb after stroke (BoTULS) trial: effect on impairment, activity limitation, and pain","volume":"42","author":"Shaw","year":"2011","journal-title":"Stroke"},{"issue":"5","key":"10.1016\/j.jhsa.2026.02.023_bib8","doi-asserted-by":"crossref","first-page":"827","DOI":"10.1093\/neuros\/nyab303","article-title":"Highly selective partial neurectomies for spasticity: a single-center experience","volume":"89","author":"Mahan","year":"2021","journal-title":"Neurosurgery"},{"issue":"7","key":"10.1016\/j.jhsa.2026.02.023_bib9","doi-asserted-by":"crossref","first-page":"708","DOI":"10.1177\/17531934211027499","article-title":"Hyperselective neurectomy for the treatment of upper limb spasticity in adults and children: a prospective study","volume":"46","author":"Leclercq","year":"2021","journal-title":"J Hand Surg Eur Vol"},{"issue":"4","key":"10.1016\/j.jhsa.2026.02.023_bib10","doi-asserted-by":"crossref","first-page":"945","DOI":"10.3390\/jcm13040945","article-title":"Surgical treatment in post-stroke spastic hands: a systematic review","volume":"13","author":"Hurtado-Olmo","year":"2024","journal-title":"J Clin Med"},{"key":"10.1016\/j.jhsa.2026.02.023_bib11","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1016\/j.wneu.2024.04.084","article-title":"Nerve-targeted surgical treatments for spasticity: a narrative review","volume":"187","author":"Ran","year":"2024","journal-title":"World Neurosurg"},{"issue":"8","key":"10.1016\/j.jhsa.2026.02.023_bib12","doi-asserted-by":"crossref","first-page":"695","DOI":"10.1177\/1545968313491002","article-title":"A randomized controlled trial of selective neurotomy versus botulinum toxin for spastic equinovarus foot after stroke","volume":"27","author":"Bollens","year":"2013","journal-title":"Neurorehabil Neural Repair"},{"issue":"5","key":"10.1016\/j.jhsa.2026.02.023_bib13","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1111\/j.1468-1331.2008.02112.x","article-title":"Comparison of botulinum toxin injection and neurotomy in patients with distal lower limb spasticity","volume":"15","author":"Rousseaux","year":"2008","journal-title":"Eur J Neurol"},{"issue":"2","key":"10.1016\/j.jhsa.2026.02.023_bib14","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1016\/j.rehab.2014.12.003","article-title":"Comparison between tibial nerve block with anaesthetics and neurotomy in hemiplegic adults with spastic equinovarus foot","volume":"58","author":"Deltombe","year":"2015","journal-title":"Ann Phys Rehabil Med"},{"key":"10.1016\/j.jhsa.2026.02.023_bib15","series-title":"Medicare physician fee schedule procedure price lookup comparison file (CY 2025)","year":"2024"},{"issue":"11","key":"10.1016\/j.jhsa.2026.02.023_bib17","doi-asserted-by":"crossref","first-page":"1448","DOI":"10.1177\/17531934251363111","article-title":"Hyperselective neurectomy for the treatment of upper limb spasticity: a long-term follow-up","volume":"50","author":"Chung","year":"2025","journal-title":"J Hand Surg Eur Vol"},{"issue":"7","key":"10.1016\/j.jhsa.2026.02.023_bib18","doi-asserted-by":"crossref","first-page":"529","DOI":"10.2106\/JBJS.M.01577","article-title":"Tendon transfer surgery in upper-extremity cerebral palsy is more effective than botulinum toxin injections or regular, ongoing therapy","volume":"97","author":"Van Heest","year":"2015","journal-title":"J Bone Joint Surg Am"},{"issue":"4","key":"10.1016\/j.jhsa.2026.02.023_bib19","doi-asserted-by":"crossref","DOI":"10.1016\/j.jhsa.2023.10.004","article-title":"Clinical recovery of spastic finger flexion using hyperselective neurectomy: a case series","volume":"50","author":"Emamhadi","year":"2025","journal-title":"J Hand Surg Am"},{"issue":"2","key":"10.1016\/j.jhsa.2026.02.023_bib20","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1097\/PRS.0b013e3181c91501","article-title":"Fundamental principles of conducting a surgery economic analysis study","volume":"125","author":"Kotsis","year":"2010","journal-title":"Plast Reconstr Surg"},{"key":"10.1016\/j.jhsa.2026.02.023_bib21","doi-asserted-by":"crossref","DOI":"10.3389\/fresc.2021.709969","article-title":"Surgical approaches to upper limb spasticity in adult patients: a literature review","volume":"2","author":"Hashemi","year":"2021","journal-title":"Front Rehabil Sci"},{"issue":"2","key":"10.1016\/j.jhsa.2026.02.023_bib22","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1053\/jhsu.1999.0323","article-title":"Upper extremity surgical treatment of cerebral palsy","volume":"24","author":"Van Heest","year":"1999","journal-title":"J Hand Surg Am"}],"container-title":["The Journal of Hand Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0363502326001723?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0363502326001723?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T08:57:58Z","timestamp":1785747478000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0363502326001723"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8]]},"references-count":21,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["S0363502326001723"],"URL":"https:\/\/doi.org\/10.1016\/j.jhsa.2026.02.023","relation":{},"ISSN":["0363-5023"],"issn-type":[{"value":"0363-5023","type":"print"}],"subject":[],"published":{"date-parts":[[2026,8]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Comparative Cost Analysis of Surgery Versus Neurotoxin Injection for Long-Term Management of Upper-Extremity Spasticity","name":"articletitle","label":"Article Title"},{"value":"The Journal of Hand Surgery","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jhsa.2026.02.023","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 by the American Society for Surgery of the Hand. Published by Elsevier Inc.","name":"copyright","label":"Copyright"}]}}