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脑瘫痉挛性疾病的选择性背根切断术——斯洛文尼亚一项新确立的手术技术:病例报告及文献综述

Selective dorsal rhizotomy in cerebral palsy spasticity - a newly established operative technique in Slovenia: A case report and review of literature.

作者信息

Velnar Tomaz, Spazzapan Peter, Rodi Zoran, Kos Natasa, Bosnjak Roman

机构信息

Department of Neurosurgery, University Medical Centre Ljubljana, Ljubljana 1000, Slovenia.

Department of Neurophysiology, University Medical Centre Ljubljana, Ljubljana 1000, Slovenia.

出版信息

World J Clin Cases. 2019 May 26;7(10):1133-1141. doi: 10.12998/wjcc.v7.i10.1133.

Abstract

BACKGROUND

Spasticity affects a large number of children, mainly in the setting of cerebral palsy, however, only a few paediatric neurosurgeons deal with this problem. This is mainly due to the fact that until 1979, when Fasano has published the first series of selective dorsal rhizotomy (SDR), neurosurgeons were able to provide such children only a modest help. The therapy of spasticity has made a great progress since then. Today, peroral drugs, intramuscular and intrathecal medicines are available, that may limit the effects of the disease. In addition, surgical treatment is gaining importance, appearing in the form of deep brain stimulation, peripheral nerve procedures and SDR. All these options offer the affected children good opportunities of improving the quality of life.

CASE SUMMARY

A 15-year old boy is presented that was surgically treated for spasticity as a result of cerebral palsy. Laminotomy at L1 level was performed and L1 to S1 nerve roots were isolated and divided in smaller fascicles. Then, the SDR was made.

CONCLUSION

We describe a patient report and surgical technique of SDR that was performed in Slovenia for the first time.

摘要

背景

痉挛影响着大量儿童,主要发生在脑瘫患儿中,然而,只有少数儿科神经外科医生处理这个问题。这主要是因为在1979年法萨诺发表第一系列选择性背根切断术(SDR)之前,神经外科医生只能为这类儿童提供有限的帮助。从那时起,痉挛的治疗取得了很大进展。如今,有口服药物、肌肉注射和鞘内注射药物,这些药物可能会限制该病的影响。此外,手术治疗越来越重要,表现为深部脑刺激、周围神经手术和SDR。所有这些选择都为患病儿童提供了改善生活质量的良好机会。

病例摘要

介绍一名15岁男孩,因脑瘫导致痉挛而接受手术治疗。在L1水平进行椎板切开术,分离L1至S1神经根并将其分成较小的束。然后,进行了SDR。

结论

我们描述了在斯洛文尼亚首次进行的SDR的一份患者报告及手术技术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b8e6/6547316/9fe7ef9050ff/WJCC-7-1133-g001.jpg

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