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选择性背根切断术的术前评估

Preoperative Assessments for Selective Dorsal Rhizotomy.

作者信息

Lee Olivia Shien Hui

机构信息

The Royal Children's Hospital, Melbourne, Australia.

出版信息

Adv Tech Stand Neurosurg. 2025;51:81-96. doi: 10.1007/978-3-031-86441-4_7.

Abstract

Selective dorsal rhizotomy (SDR) in cerebral palsy care aims to improve gait and function in ambulatory children and enhance comfort in nonambulatory children. This assessment and planning process for SDR requires a multidisciplinary team to work closely with patients and families to weigh the benefits and risks of SDR. Preoperative assessments allow the clinical team to select suitable candidates, set realistic goals, and optimise outcomes. These evaluations include physical measures, assessment of gross motor function and functional daily living skills, and gait analysis to better quantify the impact of spasticity in the SDR candidate. Further orthopaedic evaluations are required to identify pain and musculoskeletal issues, guiding subsequent post-SDR interventions. Additionally, assessments of quality-of-life assessments ensure a comprehensive rehabilitation plan that includes psychosocial support. This chapter discusses the comprehensive preoperative rehabilitation assessments that assist clinicians and families in making shared decisions about SDR.

摘要

在脑瘫治疗中,选择性背根切断术(SDR)旨在改善能行走儿童的步态和功能,并提高不能行走儿童的舒适度。SDR的这一评估和规划过程需要多学科团队与患者及其家庭密切合作,权衡SDR的益处和风险。术前评估使临床团队能够挑选合适的候选人、设定现实的目标并优化治疗效果。这些评估包括身体测量、粗大运动功能和功能性日常生活技能评估,以及步态分析,以更好地量化SDR候选者中痉挛的影响。还需要进一步的骨科评估来确定疼痛和肌肉骨骼问题,为SDR术后的后续干预提供指导。此外,生活质量评估确保制定全面的康复计划,其中包括心理社会支持。本章讨论了全面的术前康复评估,这些评估有助于临床医生和家庭就SDR做出共同决策。

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