选择性腰骶神经后根切断术及其方法改进

Selective Iumbosacral posterior rhizotomy and its modification

自１９９０年５月始，采用选择性腰骶神经后根切断术（ＳＰＲ）治疗下肢痉挛３０２例。其中脑瘫患者２８８例，平均年龄１０．４岁。按照Ａｓｈｗｏｒｔｈ５级法，术前肌张力平均３．８级，术后降至１．２级。作者在高选择法、电刺激技术以及分段跳跃式椎板切除显露神经后根等方面对传统的ＳＰＲ术式做了改进。１２２例随访超过２年，痉挛解除有效率达９６．６％，功能改善率达８３．６％。本文还对ＳＰＲ解除痉挛的可行性、手术方法改进的意义等进行了讨论。

Three hundreds and two patients with the spasticrty of lower limbs have been treated with lumbosacral selective posterior rhizotomy(SPR) since May, 1990. 288 patients of 302 cases had cerebral palsy with an average age of 10. 4 years. According to Ashworth 5 scales,the tone of muscle averaged out to 3. 8 scales. Tranditional SPR method was modified in the hyperselective,electrical stimulation and restrictive laminectomy. Follow up for over 2 years in 122 patients showed that the effective rate of reducing spasticity was 96. 6% and functional improvement rate 83. 6% .