脑瘫儿童选择性脊神经后根切断术术前爬行能力与术后下肢功能改善的关联分析

Predictive value of crawling ability for prognostication of the functional amelioration of children with cerebral palsy after selective posterior rhizotomy

目的 :分析术前爬行能力与术后下肢功能 ,特别是独立行走能力的关系。方法 :以量化功能的方式评估选择性脊神经后根切断术 (SPR)后下肢功能 ,将爬行功能分为A -D4个等级 ,同时将下肢功能分别量化 ,观察各级患儿手术前、后的功能变化 ,并统计分析手术前、后功能差异。结果 :脑瘫患者SPR术后肌张力明显降低 ,下肢各项功能显著改善 ;术前爬行能力良好的患儿术后下肢各项功能及独立行走与爬行能力差的患者有显著性差异。结论

Objective:To investigate functional changes of lower extremities after selective posterior rhizortomy,and to evaluate the value of crawling ability as a predictor of walking postoperatively.Method:To observe the function of lower limbs with quantitative functional measurement,and analyze the relation between walk ability after SPR and preoperative crawling stage.Result:(1)Muscle tone was significantly decreased,and the development of function of lower limbs was obvious.(2)The achievement was progressing in 1 year and 2 year follow up groups.(3)The ability of crawling was closely related with walk ability after SPR.Conclusion:SPR decreases spasticity and increases lower extremity range of motion in children with cerebral palsy and appears to be associated with functional improvements.The ability of crawling is a predictive reference of ability to walk after selective posterior rhizotomy.