选择性腰骶神经后根切断术治疗小儿脑性下肢瘫  

Preliminary experience of selective lumbosacral posterier rhizotomy for treatment of lower limb spastic cerebral palsy

作　　者：任德胜[1] 王保利[1] 熊斌[1] 吴欣乐[1] 易申德[1] 杜香平[1] 

机构地区：[1]江西省儿童医院骨科,南昌市330006

出　　处：《中华小儿外科杂志》2009年第1期25-27,共3页Chinese Journal of Pediatric Surgery

摘　　要：目的总结选择性腰骶神经后根切断术（SPR手术）治疗脑性下肢瘫的临床经验。方法对1994年4月至2005年6月SPR手术随诊2年以上的52例脑性下肢瘫患儿进行回顾性分析。结果术后随诊2～10年（平均4年2个月），49例增高的肌张力缓解，步态改善；2例增高的肌张力得到了缓解，但步态无明显改善；1例发生轻度膝反屈。没有发生切口感染、脑脊液漏及脊柱失稳等并发症者。结论严格掌握手术适应证，相关节段与侧别之高兴奋性（低阈值）脊神经后根小束切断比例的合适与选择正确，持之以恒的康复训练是取得良好手术效果的关键。Objective To review our preliminary experience of sacral posterior rhizotomy （SPR） operation for treating spastic cerebral palsy of lower limb. Methods From January 1994 to June 2005, 52 patients of lower limb spastic cerebtal palsy underwent selective lumbosacral posterior rhizotomies. The results of followed-up were retrospectively analyzed. Results The patients wire followed up for 2 10 Years （mean 4. 2 years）, post-operatively. There were 49 patients with both spastivity reduction and gait improvement,2 patients with spastivity reduction, but without gait improvement and 1 patient with genu recurvature. Wound infection,leakage of cerebrospinal fluid or unstability of lumbar column was not detected post-operatively. Conclusions Clear indication, accurate localization of the affected segment are the key to successful outcome.

关 键 词：脑性瘫痪 脊神经根切断术 临床分析 治疗方法 

分 类 号：R686[医药卫生—骨科学]