选择性脊神经后根切断术治疗痉挛性脑瘫的综述

目的探讨选择性脊神经后根切断术（ＳＰＲ）治疗痉挛性脑瘫的适应证、禁忌证及手术方法，提高治疗效果，降低其并发症发生率。方法广泛查阅近期有关ＳＰＲ治疗痉挛性脑瘫的文献，综述其解除痉挛的机理，手术适应证、禁忌证，手术方法，术后肌张力的变化及并发症。结果ＳＰＲ选择性地切断肌梭传入神经的Ⅰα纤维，阻断骨髓γ反射环路，降低肌张力，解除肌痉挛。手术效果及并发症的发生率与适应证的选择有密切关系。脊神经切除比例小于５０％者效果良好。结论ＳＰＲ是解除痉挛性脑瘫患儿肢体痉挛的较好方法。

A REVIEW ON THE TREATMENT OF SPASTIC CEREBRAL PAL SY WITH SELECTIVE POSTERIOR RHIZOTOMY

OBJECTIVE: To inquire the indications, contraindications, and operative methods of the treatment of spastic cerebral palsy with selective posterior rhizotomy (SPR), and to improve the therapeutic results and decrease the incidence rate of complications. METHODS: The documents about SPR were extensively consulted, and the mechanisms, indications, contraindications, operative methods, muscular tension changes and complications after operation were reviewed. RESULTS: With the methods of SPR, I alpha fibers of afferent nerve were selectively amputated, reflex circle of spinal cord was locked, and the muscular tension was decreased, so myospasm was removed. The results after operation and incidence rate of complications were closely related to the indications. The therapeutic results were better when the percent of spinal nerve rhizotomy was less than 50%. CONCLUSION: It is a good method for the treatment of spastic cerebral palsy.