Central Remedial Clinic, Clontarf, Dublin, Ireland.
PLoS One. 2019 Jul 30;14(7):e0220119. doi: 10.1371/journal.pone.0220119. eCollection 2019.
To examine the short-term effects of selective dorsal rhizotomy (SDR) ± soft-tissue surgery on gait in cerebral palsy (CP) compared to matched controls with no surgical intervention.
Participants had gait analysis before and one year after SDR. Non SDR participants were retrospectively matched for age and all significant gait parameters. The SDR group was further subdivided into those who had concomitant orthopaedic surgery and those who had SDR only.
The SDR group consisted of 29 participants (mean age 5.8 years at baseline, 7.7 years at follow-up). Of these, 13 had concomitant orthopaedic surgery. The non SDR group consisted of 18 participants (mean age at baseline 6.1 years, 8.1 years at follow-up). SDR ± soft-tissue surgery significantly improved step-lengths, knee flexion at initial contact and mid-stance, ankle dorsiflexion, foot progression and timing of peak knee flexion. None of these improvements in gait were seen without surgical intervention. While more improvements were seen in those who had SDR and orthopaedic surgery, SDR only resulted in improved step-lengths, knee extension, foot progression and timing of peak knee flexion.
SDR ± soft-tissue surgery results in short-term improvements in gait which are not seen without surgical intervention. While those who had SDR and soft-tissue surgery demonstrated more changes in gait, many improvements were attributable to SDR only.
与未接受手术干预的匹配对照组相比，检查选择性脊神经后根切断术（SDR）±软组织手术对脑瘫（CP）步态的短期影响。
参与者在 SDR 前后进行步态分析。非 SDR 参与者根据年龄和所有重要的步态参数进行回顾性匹配。SDR 组进一步分为同时接受矫形手术和仅接受 SDR 的组。
SDR 组由 29 名参与者组成（基线时平均年龄为 5.8 岁，随访时为 7.7 岁）。其中 13 人同时接受矫形手术。非 SDR 组由 18 名参与者组成（基线时平均年龄为 6.1 岁，随访时为 8.1 岁）。SDR±软组织手术可显著改善步长、初始接触和站立中期的膝关节屈曲、踝关节背屈、足推进和膝关节最大屈曲时相。没有这些手术干预，就不会出现步态改善。虽然 SDR 和矫形手术的患者有更多的改善，但 SDR 仅导致步长、膝关节伸展、足推进和膝关节最大屈曲时相的改善。
SDR±软组织手术可在短期内改善步态，而不进行手术干预则不会出现这种改善。虽然 SDR 和软组织手术的患者步态变化更大，但许多改善归因于 SDR 本身。
