Graham David, Aquilina Kristian, Mankad Kshitij, Wimalasundera Neil
Faculty of Medicine, the University of Sydney, Sydney, Australia.
Institute of Neuroscience and Muscle Research, Kids Research Institute, Children's Hospital at Westmead, Sydney, Australia.
Quant Imaging Med Surg. 2018 Mar;8(2):209-218. doi: 10.21037/qims.2018.01.08.
Spastic diplegic cerebral palsy (CP) is the most common form of CP. A specific goal-oriented approach, tailored to the child, is essential to management in all forms of CP. Selective dorsal rhizotomy (SDR) is a neurosurgical procedure that permanently reduces lower limb spasticity in children with spastic diplegic CP. The current technique is performed through a single level laminectomy at the level of the conus and, with the aid of intraoperative electromyography (EMG), allows selective division of the afferent lumbosacral nerve roots. In carefully selected children, reduction in spasticity has positive effects on the growing child. SDR is associated with minimal complications and good long-term outcomes. This article describes the surgical technique and patient selection, including the importance of medical imaging, and discusses the long-term outcomes of SDR.
痉挛性双瘫型脑瘫（CP）是最常见的脑瘫形式。针对患儿量身定制的特定目标导向方法对于所有形式脑瘫的管理至关重要。选择性脊神经后根切断术（SDR）是一种神经外科手术，可永久性减轻痉挛性双瘫型脑瘫患儿的下肢痉挛。当前技术是通过在圆锥水平进行单节段椎板切除术，并借助术中肌电图（EMG），选择性切断腰骶部传入神经根。在精心挑选的患儿中，痉挛的减轻对成长中的患儿有积极影响。SDR的并发症极少，长期效果良好。本文描述了手术技术和患者选择，包括医学成像的重要性，并讨论了SDR的长期效果。
