Fukuhara Toru, Kamata Ichiro
Division of Neurosurgery, Neuro-research Institute for Stroke Care, National Okayama Medical Center, Okayama, Japan.
Neurosurgery. 2004 May;54(5):1268-72; discussion 1272-3. doi: 10.1227/01.neu.0000119605.32216.2e.
Selective posterior rhizotomy (SPR) has been performed mainly in children with cerebral palsy. Seldom has the use of SPR been reported for reduction of spasticity after stroke. We describe two elderly patients with hemiplegia who underwent unilateral SPR for pain caused by spasticity after stroke.
The first patient was a 68-year-old woman who experienced spasticity and pain in her right leg during the chronic stage of a left cerebral infarction. The second patient was an 89-year-old man who had intolerable spastic pain in his left hemiplegic leg 3 months after a right cerebral infarction.
Both patients underwent unilateral SPR on the spastic side to reduce the pain. After surgery, the patients' pain resolved. In the first patient, the ability to perform activities of daily living also improved.
Antispastic medications are often sufficient for treatment of post-stroke spasticity. In selected cases, however, SPR can be beneficial for improving painful spasticity.
选择性后根切断术（SPR）主要用于治疗脑瘫患儿。很少有关于将SPR用于减轻中风后痉挛的报道。我们描述了两名偏瘫老年患者，他们因中风后痉挛引起的疼痛接受了单侧SPR手术。
首例患者为一名68岁女性，在左侧脑梗死慢性期出现右腿痉挛和疼痛。第二例患者是一名89岁男性，在右侧脑梗死3个月后，左侧偏瘫腿出现难以忍受的痉挛性疼痛。
两名患者均在痉挛侧接受了单侧SPR手术以减轻疼痛。术后，患者的疼痛得以缓解。首例患者的日常生活活动能力也得到了改善。
抗痉挛药物通常足以治疗中风后痉挛。然而，在某些特定情况下，SPR可能有助于改善疼痛性痉挛。
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