Adams J, Cahan L D, Perry J, Beeler L M
Physical Therapy Program, California State University, Northridge 91330, USA.
Pediatr Neurosurg. 1995;23(2):76-81. doi: 10.1159/000120940.
Fourteen ambulatory patients with spastic cerebral palsy were evaluated prior to and 6 months following selective dorsal rhizotomy. An instrumented gait analysis identified significant improvements in foot contact patterns, velocity and stride length. The high incidence of postoperative valgus, excessive dorsiflexion and persistent knee flexion during gait was attributed to significant weakness and hypotonicity in the plantar flexors, as well as residual hamstring spasticity (p < 0.05). Sectioning of fewer S-1 rootlets may preserve plantar flexion strength and enhance stance stability by preventing postoperative increases in dorsiflexion and knee flexion. Orthotic prescription for ankle instability should be a routine postoperative consideration.
对14例痉挛性脑瘫门诊患者在选择性背根切断术前及术后6个月进行了评估。仪器化步态分析显示，足部接触模式、速度和步幅有显著改善。步态中术后外翻、背屈过度和膝关节持续屈曲的高发生率归因于跖屈肌明显无力和张力减退，以及腘绳肌残余痉挛（p<0.05）。切断较少的S-1神经根小分支可能通过防止术后背屈和膝关节屈曲增加来保留跖屈力量并增强站立稳定性。对于踝关节不稳定的矫形器处方应作为术后常规考虑事项。
