Chicoine M R, Park T S, Vogler G P, Kaufman B A
Department of Neurological Surgery, St. Louis Children's Hospital, Missouri, USA.
Neurosurgery. 1996 Apr;38(4):711-4; discussion 714.
Serial evaluations were completed after selective dorsal rhizotomy on 90 children with spastic cerebral palsy to analyze whether age, the preoperative gait score, voluntary dorsiflexion at the ankle, the diagnosis (quadriplegia or diplegia), or the length of follow-up correlated with the ability to walk after rhizotomy. The preoperative gait score (P < 0.0001), the diagnosis (diplegia versus quadriplegia, P < 0.0001), unilateral dorsiflexion (P = 0.0029), and bilateral dorsiflexion (P < 0.0001) were significant predictors of the maximal postoperative gait score in the univariate regression analysis, but only the preoperative gait score (P < 0.0001) and the diagnosis (P = 0.0015) retained significant predictive power in the multivariate analysis. These data suggest that the preoperative gait score and the diagnosis are the strongest predictors of ability to walk after selective dorsal rhizotomy. Dorsiflexion demonstrated predictive power only in the univariate model, suggesting that it might have some prognostic value but less than the preoperative gait score or the diagnosis.
对90例痉挛性脑瘫患儿进行选择性背根切断术后完成了系列评估，以分析年龄、术前步态评分、踝关节主动背屈、诊断结果（四肢瘫或双瘫）或随访时间是否与背根切断术后的行走能力相关。在单因素回归分析中，术前步态评分（P < 0.0001）、诊断结果（双瘫与四肢瘫，P < 0.0001）、单侧背屈（P = 0.0029）和双侧背屈（P < 0.0001）是术后最大步态评分的显著预测因素，但在多因素分析中，只有术前步态评分（P < 0.0001）和诊断结果（P = 0.0015）保留了显著的预测能力。这些数据表明，术前步态评分和诊断结果是选择性背根切断术后行走能力的最强预测因素。背屈仅在单因素模型中显示出预测能力，表明它可能具有一定的预后价值，但低于术前步态评分或诊断结果。
