As a further option for you to consider in your treatment program, selective denervation is a choice many ST'rs will face. As with chemo (chemical) denervation with botox/myobloc this operation is based on the same principal - denervation, meaning loss of nerve supply. Simply stated the surgeon determines through a comprehensive EMG exam just what muscles are active and causing the problems. Once they are determined he/she will snip the nerve pathways back about 1 ½ inches. The most important point with this operation is to find a surgeon who is the most competent. Included within this section are several great articles by the world's foremost surgeon for this operation, Dr. Carlos Arce. He has performed well over 400 surgeries.