Reynolds Renee M, Morton Ryan P, Walker Marion L, Massagli Teresa L, Browd Samuel R
Department of Neurological Surgery, University of Washington, Seattle, Washington;
J Neurosurg Pediatr. 2014 Sep;14(3):266-70. doi: 10.3171/2014.5.PEDS13459. Epub 2014 Jun 27.
Selective dorsal rhizotomy may have a role in the management of spinal cord injury (SCI)-induced spasticity. Spasticity and spasms are common sequelae of SCI in children. Depending on the clinical scenario, treatments may include physical and occupational therapy, oral medications, chemodenervation, and neurosurgical interventions. Selective dorsal rhizotomy (SDR) is used in the management of spasticity in selected children with cerebral palsy, but, to the authors' knowledge, its use has not been reported in children with SCI. The authors describe the cases of 3 pediatric patients with SCI and associated spasticity treated with SDR. Two of the 3 patients have had significant long-term improvement in their preoperative spasticity. Although the third patient also experienced initial relief, his spasticity quickly returned to its preoperative severity, necessitating additional therapies. Selective dorsal rhizotomy may have a place in the treatment of selected children with spasticity due to SCI.
选择性背根切断术可能在脊髓损伤（SCI）所致痉挛的治疗中发挥作用。痉挛和抽搐是儿童SCI的常见后遗症。根据临床情况，治疗方法可能包括物理治疗和职业治疗、口服药物、化学去神经支配以及神经外科干预。选择性背根切断术（SDR）用于治疗部分患有脑瘫的儿童的痉挛，但据作者所知，其在患有SCI的儿童中的应用尚未见报道。作者描述了3例接受SDR治疗的患有SCI及相关痉挛的儿科患者的病例。3例患者中有2例术前痉挛状况得到了显著的长期改善。尽管第3例患者最初也有所缓解，但其痉挛很快又恢复到术前的严重程度，需要额外的治疗。选择性背根切断术可能在治疗部分因SCI导致痉挛的儿童中占有一席之地。
