选择性脊神经后根切断术后下肢功能评估

目的：评估选择性脊神经根切断术后下肢功能，同时分析术前爬行能力与术后行走能力的关键。方法：将下肢功能（包括肌张力）分别量化，观察手术前，后的变化，并统计分析手术前，后功能差异。结果：（1）术后肌张力明显降低，下肢各项功能显著改善；（2）术后2年下肢功能进一步改善；（3）术前爬行能力良好的患儿术后下肢各项功能及独立行走与爬行能力差的患儿比较有显著性差异。结论：选择性脊神经后根切断术能够有效地解除痉挛，改善下肢功能，术前爬行能力对判断手术预后能够提供参考。

Functional Evaluation of Lower Extremities After Selective Posterior Rhizotomy

Objective: To evaluate the functional changes of lower extremities and the relation between the preoperative crawling ability and postoperative walking ability following selective posterior rhizotomy (SPR) for children's cerebral palsy . Methods: The mobility of lower extremeties (including musclar tone) was quantitatively measured and the relation between preoperative crawling ability and postoperative walking ability following SPR was statistically analyzed. Results: (1) Muscular tension was significantly decressed, and functional improvement of lower limbs was obvious. (2) The improvement was continuous in 6-month and l-year follow-up groups. (3) The walking ability after SPR was closely related to preoperative crawling ability. Conclusion: Because the cerebral palsy is a nonprogressive disorder of movement resulting from damage to brain before, during or immediately after birth and is permanent, the treatment for the palsy is troublesome. Sometimes, surgery may be necessary to relieve the contractures, SPR can decrease the spasticity and increase the voluntary mobility. The preoperative ability of crawling is a predictor of ability to walk after SPR.