选择性背根切断术治疗小儿脑瘫的疗效
Effect of selective dorsal rhizotomy in the treatment of children with cerebral palsy.
作者信息
Engsberg Jack R, Ross Sandy A, Collins David R, Park Tae Sung
机构信息
Department of Neurological Surgery, Human Performance Laboratory, Center for Cerebral Palsy Spasticity, St. Louis Children's Hospital, Missouri, USA.
出版信息
J Neurosurg. 2006 Jul;105(1 Suppl):8-15. doi: 10.3171/ped.2006.105.1.8.
OBJECT
In this investigation the authors compared impairment and functional outcomes between two groups of children with cerebral palsy (CP): one group underwent selective dorsal rhizotomy (SDR) followed by intensive physical therapy (PT), and the other group underwent the latter only (PT group). Data from an age-matched group of children without disability (nondisabled [ND] group) were also collected.
METHODS
Data pertaining to the 68 children with CP were collected before any intervention and again 8 and 20 months afterwards. Data regarding the 40 children in the ND group were collected in a single session.
CONCLUSIONS
Although patients in both groups with CP were weaker than those in the ND group, they did have strength gains. Gait speed in the SDR-PT group was slower than that in the ND group preoperatively but not at 20 months postoperatively. Gait speed in the PT group remained slower than that in the ND group. The pre- to postoperative change in the Gross Motor Abilities Estimate score was significantly greater in the SDR-PT group than in the PT-only group. An effective treatment for children with CP, SDR offers gains in strength, gait speed, and overall gross motor function.
目的
在本研究中，作者比较了两组脑瘫（CP）患儿的损伤情况和功能结局：一组接受选择性背根切断术（SDR），随后进行强化物理治疗（PT），另一组仅接受后者（PT组）。还收集了年龄匹配的无残疾儿童组（非残疾[ND]组）的数据。
方法
收集了68例CP患儿在任何干预前、干预后8个月和20个月的数据。收集了ND组40名儿童在单一时间点的数据。
结论
虽然两组CP患儿都比ND组患儿虚弱，但他们确实有力量增加。SDR-PT组术前的步态速度比ND组慢，但术后20个月时并非如此。PT组的步态速度仍比ND组慢。SDR-PT组的粗大运动能力评估评分术前至术后的变化明显大于单纯PT组。SDR是一种治疗CP患儿的有效方法，可提高力量、步态速度和整体粗大运动功能。
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