神经外科手术入路

Neurosurgical Approaches.

作者信息

Madsen Peter J, Isaac Chen Han-Chiao, Lang Shih-Shan

机构信息

Department of Neurosurgery, Hospital of the University of Pennsylvania, Perelman School of Medicine, University of Pennsylvania, Silverstein 3rd Floor, 3400 Spruce Street, Philadelphia, PA 19104, USA; Division of Neurosurgery, Children's Hospital of Philadelphia, Wood Center, 6th Floor, 3401 Civic Center Boulevard, Philadelphia, PA 19104-399, USA.

出版信息

Phys Med Rehabil Clin N Am. 2018 Aug;29(3):553-565. doi: 10.1016/j.pmr.2018.04.002. Epub 2018 May 29.

DOI:10.1016/j.pmr.2018.04.002

PMID:30626515

Abstract

Neurosurgery has long had a role in the treatment of disorders of muscle hyperactivity. This article discusses the use of selective peripheral neurotomy for the treatment of focal and multifocal spasticity, selective dorsal rhizotomy for alleviation of more generalized spasticity most often in the setting of cerebral palsy, dorsal root entry zone lesioning for cases of severe spasticity in a nonfunctioning limb, and deep brain stimulation for the treatment of dystonia. For each procedure, relevant pathophysiology and basic surgical anatomy and technique are addressed. Additionally, relevant aspects of patient selection, efficacy data, and complications of these procedures are discussed.

摘要

神经外科在肌肉活动亢进性疾病的治疗中一直发挥着作用。本文讨论了选择性周围神经切断术用于治疗局灶性和多灶性痉挛，选择性背根切断术用于缓解最常见于脑瘫情况下的更广泛的痉挛，背根入髓区毁损术用于治疗无功能肢体的严重痉挛病例，以及深部脑刺激术用于治疗肌张力障碍。对于每种手术，均阐述了相关的病理生理学、基本手术解剖结构和技术。此外，还讨论了患者选择、疗效数据以及这些手术的并发症等相关方面。