Department of Paediatric Neurology, University Children's Hospital, Berne, Switzerland.
Dev Med Child Neurol. 2014 Apr;56(4):302-12. doi: 10.1111/dmcn.12277. Epub 2013 Sep 24.
Information regarding the selection procedure for selective dorsal rhizotomy (SDR) in children with spastic cerebral palsy (CP) is scarce. Therefore, the aim of this study was to summarize the selection criteria for SDR in children with spastic CP.
A systematic review was carried out using the following databases: MEDLINE, CINAHL, EMBASE, PEDro, and the Cochrane Library. Additional studies were identified in the reference lists. Search terms included 'selective dorsal rhizotomy', 'functional posterior rhizotomy', 'selective posterior rhizotomy', and 'cerebral palsy'. Studies were selected if they studied mainly children (<18y of age) with spastic CP, if they had an intervention of SDR, if they had a detailed description of the selection criteria, and if they were in English. The levels of evidence, conduct of studies, and selection criteria for SDR were scored.
Fifty-two studies were included. Selection criteria were reported in 16 International Classification of Functioning, Disability and Health model domains including 'body structure and function' (details concerning spasticity [94%], other movement abnormalities [62%], and strength [54%]), 'activity' (gross motor function [27%]), and 'personal and environmental factors' (age [44%], diagnosis [50%], motivation [31%], previous surgery [21%], and follow-up therapy [31%]). Most selection criteria were not based on standardized measurements.
Selection criteria for SDR vary considerably. Future studies should describe clearly the selection procedure. International meetings of experts should develop more uniform consensus guidelines, which could form the basis for selecting candidates for SDR.
有关痉挛型脑瘫患儿选择性脊神经后根切断术（SDR）选择程序的信息很少。因此，本研究旨在总结痉挛型脑瘫患儿 SDR 的选择标准。
使用以下数据库进行系统评价：MEDLINE、CINAHL、EMBASE、PEDro 和 Cochrane 图书馆。在参考文献中还确定了其他研究。搜索词包括“选择性脊神经后根切断术”、“功能性后根切断术”、“选择性后根切断术”和“脑瘫”。如果研究主要针对痉挛型脑瘫的儿童（<18 岁），如果干预措施为 SDR，如果详细描述了选择标准，且为英文，则选择研究。对证据水平、研究实施和 SDR 选择标准进行评分。
共纳入 52 项研究。16 项国际功能、残疾和健康分类模型领域报告了选择标准，包括“身体结构和功能”（详细描述痉挛[94%]、其他运动异常[62%]和力量[54%]）、“活动”（粗大运动功能[27%]）和“个人和环境因素”（年龄[44%]、诊断[50%]、动机[31%]、既往手术[21%]和随访治疗[31%]）。大多数选择标准并非基于标准化测量。
SDR 的选择标准差异很大。未来的研究应清楚地描述选择程序。专家国际会议应制定更统一的共识指南，该指南可为 SDR 候选者的选择提供依据。
