Schijman E, Erro M G, Meana N V
Division of Neurosurgery, Hospital de Niños Ricardo Gutierrez, Buenos Aires, Argentina.
Childs Nerv Syst. 1993 Dec;9(8):474-7. doi: 10.1007/BF00393554.
The increasing interest in selective posterior rhizotomy for reduction of spasticity in children with cerebral palsy and other neurological disorders comes from the selectivity that this procedure has achieved with intraoperative electromyographic monitoring. Thirty patients were operated on between April 1989 and October 1991. Spasticity was of cerebral origin in 27 cases and secondary to spinal cord lesion in 3 others. A reduction in the abnormally high muscle tone was observed in all cases, mainly in the lower extremities, but also, to a lesser degree, in the upper extremities. All patients showed functional improvements that depended on the individual preoperative condition. Even severely disabled patients with quadriplegia and intellectual impairment, whose spasticity interfered with their daily care, had a significantly improved quality of life after rhizotomy. These patients became much looser, with better swallowing and less drooling, and were much more easily managed by their caretakers. Preliminary results with follow-up from 1 to 30 months indicates that selective posterior rhizotomy is a safe procedure which contributes to significant functional improvement in spastic patients.
对选择性后根切断术治疗脑瘫及其他神经系统疾病患儿痉挛的兴趣日益增加，源于该手术在术中肌电图监测下所实现的选择性。1989年4月至1991年10月期间，对30例患者进行了手术。27例痉挛源于脑部，另外3例继发于脊髓损伤。所有病例均观察到异常高肌张力降低，主要在下肢，上肢也有程度较轻的降低。所有患者均表现出功能改善，改善程度取决于术前个体状况。即使是患有四肢瘫痪和智力障碍的严重残疾患者，其痉挛妨碍日常护理，在进行后根切断术后生活质量也有显著改善。这些患者变得更加放松，吞咽更好，流口水减少，护理人员照料起来也更加容易。1至30个月随访的初步结果表明，选择性后根切断术是一种安全的手术，有助于痉挛患者实现显著的功能改善。
