McLaughlin T P, Banta J V, Gahm N H, Raycroft J F
J Bone Joint Surg Am. 1986 Jan;68(1):88-94.
Intraspinal rhizotomy alone or in combination with excision of the scarred conus medullaris distal to the level of the cord anomaly was used in thirteen patients with myelomeningocele at the thoracolumbar level whose care was complicated by recurrent deformity of the lower extremities that was caused by persistent spasticity. When examined at an average follow-up of 5.3 years, all patients were free of spasticity, had manageable lower extremities, and were able to sit in a wheelchair with ease. Twelve patients had no change in the status of the urinary tract, but one patient noted an adverse change in urinary status with increased wetness between intermittent catheterizations. Intraspinal rhizotomy alone or in combination with distal cordectomy should be used only in patients with congenital paraplegia in whom reflex motor activity has caused recurrent deformity of the lower extremities that cannot be controlled by the use of braces or operations on the lower extremities, or both.
对于13例胸腰段脊髓脊膜膨出且因持续性痉挛导致下肢反复畸形而使治疗复杂化的患者，采用单纯脊髓内神经根切断术或联合切除脊髓异常平面远端的瘢痕性脊髓圆锥。在平均5.3年的随访检查中，所有患者痉挛消失，下肢功能可控制，能够轻松坐在轮椅上。12例患者尿路状况无变化，但1例患者间歇性导尿期间尿湿增加，尿路状况出现不良变化。单纯脊髓内神经根切断术或联合脊髓远端切除术仅应用于先天性截瘫患者，这类患者的反射性运动活动导致下肢反复畸形，无法通过使用支具或下肢手术（或两者）来控制。
