Garriz-Luis M, Sanchez-Carpintero R, Alegre M, Tejada S
Clinica Universitaria de Navarra, Pamplona, Espana.
Clinica Universitaria de Navarra, 31008 Pamplona, Espana.
Rev Neurol. 2018 Jun 1;66(11):387-394.
Infantile cerebral palsy is a well-known condition, the prevalence of which has varied only slightly over the years. The most common subtype is spastic diplegia, and spasticity is the most disabling symptom. Its treatment involves a multidisciplinary intervention that includes rehabilitation, the use of drugs, and orthopaedic and nervous system surgery, where selective dorsal rhizotomy is a prominent procedure.
To present a thorough review of the use, indication and long-term consequences of selective dorsal rhizotomy.
It is a minimally invasive procedure aimed at reducing spasticity in the lower extremities in order to improve the ability to walk, lessen pain, facilitate care in everyday life and diminish the need for orthopaedic surgery. The literature contains a wide range of criteria for its use, and the main indication is spastic diplegia with the absence of dystonia. It is routinely performed in several countries, while we have no evidence of its application in ours.
Following the literature review, we believe there is enough experience to state that selective dorsal rhizotomy is a safe and simple technique from which many patients with spasticity of the lower limbs secondary to infantile cerebral palsy can benefit in both the short and the long term.
小儿脑性瘫痪是一种广为人知的病症,其患病率多年来仅有轻微变化。最常见的亚型是痉挛性双侧瘫,痉挛是最致残的症状。其治疗涉及多学科干预,包括康复治疗、药物使用以及骨科和神经系统手术,其中选择性脊神经后根切断术是一项重要手术。
全面综述选择性脊神经后根切断术的应用、适应证及长期后果。
这是一种微创手术,旨在减轻下肢痉挛,以提高行走能力、减轻疼痛、便于日常生活护理并减少骨科手术需求。文献中关于其应用的标准繁多,主要适应证是无肌张力障碍的痉挛性双侧瘫。该手术在多个国家常规开展,但我们没有其在我国应用的相关证据。
通过文献综述,我们认为有足够的经验表明,选择性脊神经后根切断术是一种安全且简单的技术,许多因小儿脑性瘫痪导致下肢痉挛的患者无论短期还是长期都能从中受益。