Nishida T, Thatcher S W, Marty G R
Department of Neurology, Northwestern University Medical School, Chicago, IL 60611, USA.
Childs Nerv Syst. 1995 Jul;11(7):374-80. doi: 10.1007/BF00717399.
Although selective posterior rhizotomy (SPR) was pioneered as early as 1913, only over the past decade has the procedure gained popular use for the treatment of spasticity in cerebral palsy. The medical knowledge base regarding this procedure is expanding, and surgical techniques continue to be revised. We present our 7 years of experience in treating spastic cerebral palsy using SPR. The aspects of preoperative evaluation used by the multidisciplinary team to determine candidacy are outlined. The surgical procedure is detailed with a particular emphasis on the role of intraoperative nerve root stimulation to aid in selection for rootlet sectioning. Historical nerve stimulation protocols are reviewed and compared to our findings over the years. The functional goals are discussed in the context of the postoperative evaluation and therapies. Specific outcome in relation to joint range of motion, self care tasks, and ambulation is reported. The paper outlines a concise overview of our experiences and will assist the clinician in defining a protocol and expectations for SPR.
尽管选择性后根切断术（SPR）早在1913年就已开创，但仅在过去十年中，该手术才在治疗脑瘫痉挛方面得到广泛应用。关于该手术的医学知识库正在不断扩展，手术技术也在持续修订。我们介绍了我们使用SPR治疗痉挛性脑瘫的7年经验。概述了多学科团队用于确定手术候选资格的术前评估方面。详细介绍了手术过程，特别强调了术中神经根刺激在辅助选择神经根切断方面的作用。回顾了历史上的神经刺激方案并与我们多年来的发现进行了比较。在术后评估和治疗的背景下讨论了功能目标。报告了与关节活动范围、自我护理任务和行走相关的具体结果。本文概述了我们的经验要点，将有助于临床医生确定SPR的方案和预期。
