Wimalasundera Neil
Royal Children's Hospital, Melbourne, Australia.
Adv Tech Stand Neurosurg. 2025;51:193-208. doi: 10.1007/978-3-031-86441-4_14.
Selective dorsal rhizotomy (SDR) has been practiced for many years; however, standardization of processes such as the surgical technique and rehabilitation protocols are only relatively recent phenomenon. Comparing data from various studies can be limited due to temporal changes in practice, different selection criteria for SDR, the heterogeneity of cerebral palsy and variable rehabilitation protocols. This chapter reviews the available evidence in relation to best practice for rehabilitation following SDR and explores factors affecting the short- and long-term outcome following SDR. This includes more easily measurable factors, such as the child's preoperative Gross Motor Function Measurement (GMFM) and severity of spasticity, to social and cognitive factors which can affect participation in rehabilitation.
选择性背根切断术(SDR)已应用多年;然而,诸如手术技术和康复方案等流程的标准化只是相对较新的现象。由于实践中的时间变化、SDR的不同选择标准、脑瘫的异质性以及康复方案的差异,比较不同研究的数据可能会受到限制。本章回顾了与SDR术后康复最佳实践相关的现有证据,并探讨了影响SDR术后短期和长期结果的因素。这包括更容易测量的因素,如儿童术前的粗大运动功能测量(GMFM)和痉挛严重程度,以及可能影响康复参与度的社会和认知因素。