选择性腰5、骶1脊神经后根切断术加内收肌切断术治疗下肢痉挛的研究

采用选择性腰 5、骶 1脊神经后根切断术 内收肌切断术治疗成人脑外伤后、脑瘫、脊髓损伤后下肢痉挛 2 9例 ,术前术后进行步态分析。术前 3天进行步态分析 ,术中于大腿内侧将内收肌腱性部分切断松解内收肌 ,将痉挛下肢的腰 5、骶 1的脊神经后根进行分束 ,电刺激仪测阈值后将阈值较低的神经束切断。2 9例随访 3年 ,痉挛解除率 90 %,功能改善率 80 %。术后步态与术前比较有明显改善。说明选择性腰 5、骶 1脊神经后根切断术 内收肌切断术能较有效的治疗成人脑外伤后、脑瘫、脊髓损伤后肢体痉挛。

GAIT ANALYSIS OF SPASTIC LIMBS AFTER TREATMENT WITH SELECTIVE POSTERIOR RHIZOTOMY OF L5-S1 COMBINED WITH SEVERANCE OF ADDUCTOR MUSCLE

The adductor tendon was partially divided. The posterior roots of L 2-S 1 were separated from anterior roots and they were split into fasciculi. The fasciculi showing low threshold to electric stimulation were sectioned. Gait analysis was conducted both preoperatively and postoperatively. This operative strategy was carried out in 16 cases. The result of the treatment was satisfactory after being followed-up for 4 years. Spasticity was reduced by 90 percent and the rate of functional improvement was 80 percent. The results indicated that selective posterior rhizotomy of L 5-S 1, combined with division of addactor muscle was effective in the treatment of spastic lower limbs as a result of brain injury, cerebral palsy, and spinal cord injury.