Shin Dong-Keun, Jung Young-Jin, Hong Joo-Chul, Kim Min-Su, Kim Seong-Ho
Department of Neurosurgery, College of Medicine, Yeungnam University, Daegu, Korea.
J Korean Neurosurg Soc. 2010 Sep;48(3):236-9. doi: 10.3340/jkns.2010.48.3.236. Epub 2010 Sep 30.
The purpose of this study was to investigate the effectiveness and outcome of selective musculocutaneous neurotomy (SMcN) for spastic elbow.
We retrospectively reviewed the medical records of 14 patients with spasticity of their elbows. The patients were selected using clinical and analytical scales, as well as nerve block tests, for assessment. Their mean age was 37.29 years (range, 19-63 years). SMcN was performed for these patients, and the mean follow-up period was 30.71 months (range, 19-54 months).
The modified Ashworth scale (MAS) scores recorded before and after the SMcN showed that the patients' mean preoperative MAS score of 3.28 ± 0.12 was improved to 1.71 ± 0.12, 1.78 ± 0.18, 1.92 ± 0.16 and 1.78 ± 0.18 at postoperative 3, 6, 12 months and last follow-up, respectively. On the basis of a visual analogue score ranging from 0-100, the patients' mean degree of satisfaction score was 65.00 ± 16.52 (range, 30-90).
We believe that SMcN can be a good and effective treatment modality with low morbidity in appropriately selected patients who have localized spastic elbow with good antagonist muscles and without joint contracture.
本研究旨在探讨选择性肌皮神经切断术(SMcN)治疗痉挛性肘部的有效性和结果。
我们回顾性分析了14例肘部痉挛患者的病历。通过临床和分析量表以及神经阻滞试验对患者进行评估以入选。他们的平均年龄为37.29岁(范围19 - 63岁)。对这些患者实施了SMcN,平均随访期为30.71个月(范围19 - 54个月)。
SMcN前后记录的改良Ashworth量表(MAS)评分显示,患者术前平均MAS评分为3.28±0.12,术后3个月、6个月、12个月及末次随访时分别改善至1.71±0.12、1.78±0.18、1.92±0.16和1.78±0.18。基于0 - 100的视觉模拟评分,患者的平均满意度评分为65.00±16.52(范围30 - 90)。
我们认为,对于适当选择的、肘部局部痉挛且拮抗肌良好且无关节挛缩的患者,SMcN可以是一种良好且有效的治疗方式,发病率低。