选择性脊神经后根切断术配合软组织松解术治疗痉挛性脑瘫  

SELECTIVE POSTERIOR RHIZOTOMY AND SOFT-TISSUE RELEASES PROCEDURES FOR TREATMENT OF SPASTIC CEREBRAL PALSY

作　　者：陈艺新[1] 张云强[1] 陈克洲[1] 贾湘谦[1] 肖杰[1] 彭少英[1] 王兰[1] 张汇林[1] 袁平[1] 

机构地区：[1]贵州省贵阳市第四人民医院骨科

出　　处：《中华显微外科杂志》1997年第4期260-263,共4页Chinese Journal of Microsurgery

摘　　要：目的：回顾性分析自１９９４年至１９９６年３月采用选择性脊神经后根切断术配合软组织松解术治疗痉挛性脑瘫２５例的治疗效果。方法：根据脑瘫肌张力与临床表现分别选择不同的神经节段和切断比例（双或单侧）。本组Ｌ２～Ｓ１１１例（双）；Ｌ３～Ｓ１５例（双）、２例（单）；Ｌ４～Ｓ１３例（双），２例（单）；Ｌ５～Ｓ１２例（双）。比例为Ｌ２２０％、Ｌ３２５％、Ｌ４３５％、Ｌ５４０％、Ｓ１４５％，平均４０％（±）。按选择神经后根平面，作椎板入路改良１３例：保留Ｌ４骨桥的“有限”板切除术５例、椎板翻转回植术４例、小开窗术４例，力图保持脊柱稳定；再配合软组织松解术治疗遗留固定挛缩达到进一步提高疗效。结果：平均随访１年，优良率达到８８％。结论：改良的ＳＰＲ方法可能是提高治疗痉挛性脑瘫有效的新方法。Objective:To retrospect and analyze the curative effect with improved selective posterior rhizotomy (SPR) and soft tissue releases procedures for the treatment of 25 cases of the spastic cerebral palsy from 1994 to march 1996 Methods:Improvement of method of SPR was according to the muscle tone of cerebral palsy and indication of clinical to select different the plane of root nerve with proportion of incision (between at L 2～S 1 level):L 2～S 111 cades (bilateral)、L 3～S 1 5 cases(bilateral),2 cases(lateral);L 4～S 1 3 cases (bilateral),2 cases(lateral); L ～S 1 2 cases(bilateral). The Propotion of incision:L 220%‘L 3 25%、L 4 35%、L 5 40%、S 1 45%,to average 40%(±) The lamina open the window included to retain the bridge of bone at L 4 was limited laminectomy 5 cases complete lamina be reversed replantation of 4 cases and small open the window of 4 cases for preserving the spinal cord stability It was increased curative effect that the soft tissue releases procedures were treated fixative contraction of sequelae of cerebral palsy Result:The result was satisfactory with excellent and good rate were 88% Conclusion:The procedure of improved SPR may be a new and increased curative effect method for treatment of spastic cerebral

关 键 词：脊神经后根切断 软组织松解术 脑瘫 

分 类 号：R742.305[医药卫生—神经病学与精神病学]