Farmer Jean-Pierre, Sabbagh Abdulrahman J
The Montreal Children's Hospital, McGill University Health Center, Room C-811, 2300 Tupper Street, Montreal, QC, H3H 1P3, Canada.
Childs Nerv Syst. 2007 Sep;23(9):991-1002. doi: 10.1007/s00381-007-0398-2. Epub 2007 Jul 21.
Selective dorsal rhizotomy (SDR) is a surgical technique developed over the past decades to manage patients diagnosed with cerebral palsy suffering from spastic diplegia. It involves selectively lesioning sensory rootlets in an effort to maintain a balance between elimination of spasticity and preservation of function. Several recent long-term outcome studies have been published. In addition, shorter follow-up randomized controlled studies have compared the outcome of patients having undergone physiotherapy alone with those that received physiotherapy after selective dorsal rhizotomy.
In this account, we will discuss the rationale and outcome after SDR. The outcome is addressed in terms of the gross motor function measurement scale (GMFM), degree of elimination of spasticity, strength enhancement, range of motion, fine motor skills, activity of daily living, spastic hip, necessity for postoperative orthopedic procedures, bladder and sphincteric function, and finally possible early or late complications associated with the procedure.
We conclude that SDR is a safe procedure, which offers durable and significant functional gains to properly selected children with spasticity related to cerebral palsy.
选择性背根切断术（SDR）是过去几十年发展起来的一种外科技术，用于治疗被诊断为患有痉挛性双侧瘫的脑瘫患者。它包括选择性地损伤感觉神经根丝，以努力在消除痉挛和保留功能之间保持平衡。最近已经发表了几项长期结果研究。此外，较短随访期的随机对照研究比较了仅接受物理治疗的患者与接受选择性背根切断术后再接受物理治疗的患者的结果。
在本文中，我们将讨论选择性背根切断术的理论依据和结果。结果从粗大运动功能测量量表（GMFM）、痉挛消除程度、力量增强、活动范围、精细运动技能、日常生活活动能力、痉挛性髋关节、术后骨科手术的必要性、膀胱和括约肌功能，以及最后与该手术相关的可能的早期或晚期并发症等方面进行阐述。
我们得出结论，选择性背根切断术是一种安全的手术，对于适当选择的与脑瘫相关的痉挛性儿童，它能带来持久且显著的功能改善。
