选择性脊神经后根切断结合矫形手术治疗脑瘫所致肢体痉挛

作者采用选择性脊神经后根切断术(SPR)结合矫形术治疗39例脑瘫所致肢体痉挛患者,通过临床实践和6月～4年随访观察,发现SPR能够有效地解除肌肉痉挛,纠正动力性畸形,不易复发,但对于较明显的固定挛缩畸形,必须同时配合Ⅱ期矫形手术,方能达到预期效果。强调术后肌力强化训练的必要性。对于手术患者年龄选择、手术适应证、手术操作技术、神经根切断比例及疗效判断标准提出了自己的看法。

Selective Posterior Rhizotomy Combined with Orthopaedic Surgery for Treatment of Spasticity of Cerebral Palsy in the Limbs

Selective posterior rhizotomy (SPR)combined with secondary orthopaedic surgery was performed in 39 cases with spasticity of the limbs due to cerebral palsy. Based on the experiences and follow-up from 6 months to 4 years,the authors have concluded that the SPR can radically relieve the muscular spasticity of the limb and correct the alterable deformity of limbs with low recurrence, but for the serious and permanent contracture deformity,it is necessary that secondary orthopaedic surgery should be done. The authors emphasized that effective muscle training is necessary for the functional rehabilitation, the proper indication, the prorer age selected and the proper percentage of the posterior nerve root to be sectioned are important for obtaining satisfactory result. The essay gives account of the key points about the operation and postoperative treatment.