椎板切开复位选择性脊神经后根切断治疗痉挛性脑瘫  

Laminotomy,laminoplasty and selective posterior rhizotomy in the treatment of spastic cerebral palsy

作　　者：江晓春[1] 王贵怀[2] 徐善水[1] 李振球[1] 潘先文[1] 许安定[1] 李真保[1] 戴易[1] 王弘乐[1] 朱明峰[1] 

机构地区：[1]皖南医学院弋矶山医院神经外科,安徽省芜湖市241000 [2]北京天坛医院神经外科,100050

出　　处：《实用医学杂志》2006年第20期2379-2381,共3页The Journal of Practical Medicine

摘　　要：目的:探讨通过显微神经外科和电生理技术,进行椎板切开复位选择性脊神经后根切断术对痉挛性脑性瘫痪的治疗效果。方法:行T11～L1椎板切开复位,显微镜下在脊髓圆锥水平将L1～S2神经后根分离成神经小枝,观察电刺激神经后根小枝所诱发的肌肉收缩和肌电图反应,切断异常反应的神经后根小枝。神经后根小枝切断数目不超过60%。结果:所有病例术后肌痉挛程度立即出现明显下降,随访发现所有患者肢体运动功能均有改善,术后未出现腰椎前凸、畸形及滑脱现象。结论:T11～L1椎板切开复位,脊髓圆锥入路选择性L1～S2神经后根切断,能够有效地控制脑瘫所引起的下肢肌痉挛,改善运动功能并减少术后并发症的发生。Objective To evaluate the therapeutic effect of laminotomy, laminoplasty and selective posterior rhizotomy on spastic cerebral palsy. Methods Vertebral T11～L1 Laminotomy was performed. Dorsal nerve roots L1～S2 were microscopically separated into rootlets at level conus medullaris and those abnormal rootlets were severed according to the responses of muscle contraction and electromyography. No more than 60% of the rootlets were cut. Results An evident improvement of spasticity occurred in all the patients right after surgery. The extremity motor function of the patients was improved during the period of follow-up, no lordosis, deformity and dislocation of the vertebrae developed after surgery. Conclusions T11～L1 Laminotomy and laminoplasty and L1～S2 selective posterior rhizotomy could be helpful in controlling lower extremity spasticity secondary to cerebral palsy, improving the extremity motor function, and reducing postoperative complications.

关 键 词：脑性瘫痪 脊神经根切断术 

分 类 号：R651.1[医药卫生—外科学]