Thomas Susan Sienko, Buckon Cathleen E, Piatt Joseph H, Aiona Michael D, Sussman Michael D
Shriners Hospitals for Children, Portland, Oregon 97239, USA.
J Pediatr Orthop B. 2004 Nov;13(6):358-66. doi: 10.1097/01202412-200411000-00002.
The purpose of this study was to prospectively compare the effect of orthopedic surgery (OS) and selective dorsal rhizotomy (SDR) on muscle tone, range of motion, gait and energy efficiency in ambulatory children with spastic diplegia. Twenty-five children with a diagnosis of spastic diplegia, with a mean age of 73 months, were evaluated prior to surgery and 1 and 2 years postoperatively; however, only the preoperative and 2-year postoperative data are reported here. Eighteen children received SDR and seven received OS. Children were evaluated with the Ashworth scale for muscle tone, passive range of motion (PROM), gait analysis and oxygen consumption for energy cost. Significant improvements were seen in PROM, muscle tone, gait kinematics and oxygen cost regardless of surgical intervention. Although OS and SDR interventions influence motor function through different mechanisms, the gait and energy outcomes 2 years following OS or SDR are similar.
本研究的目的是前瞻性地比较骨科手术（OS）和选择性脊神经后根切断术（SDR）对痉挛型双瘫门诊儿童肌张力、活动范围、步态和能量效率的影响。25名诊断为痉挛型双瘫的儿童，平均年龄73个月，在手术前以及术后1年和2年进行了评估；然而，这里仅报告术前和术后2年的数据。18名儿童接受了SDR，7名接受了OS。通过Ashworth肌张力量表、被动活动范围（PROM）、步态分析和能量消耗的氧气消耗量对儿童进行评估。无论手术干预如何，PROM、肌张力、步态运动学和氧气消耗均有显著改善。尽管OS和SDR干预通过不同机制影响运动功能，但OS或SDR后2年的步态和能量结果相似。
