选择性脊神经后根切断术改善脑瘫患者下肢功能的研究进展

Advances on selective posterior rhizotomy for lower limb function in patients with cerebral palsy

脑性瘫痪是一种常见的儿童时期神经系统伤残的临床综合征,其严重影响患儿及家属的生活质量,同时给社会带来沉重的经济负担。国内外学者将选择性脊神经后根切断术应用于痉挛型脑瘫或伴有肢体痉挛的混合型脑瘫的治疗中已有很长的历史。其改善脑瘫患者下肢痉挛疗效确切,且极少出现复发现象。术后脑瘫患者结合康复治疗后,其肌力较前明显提高,关节活动度在术后即可出现明显改善,且中长期随访未见反弹,患者整体步态得到长期明显改善。笔者认为选择性脊神经后根切断术在改善脑瘫患者下肢运动功能方面疗效显著,值得推广,但必须遵循术前选择合适的病例,术中精细操作,术后及时有效康复治疗的原则,才能使其疗效更佳。

Cerebral palsy is a common clinical syndrome of neurological disability in childhood,which seriously affects the quality of life of children and their families,and brings a heavy economic burden to the society.Domestic and foreign scholars had a long history of the application of selective posterior rhizotomy for the treatment of spastic cerebral palsy or mixed cerebral palsy with limb paralysis.It is effective in improving the lower extremity spasm of patients with cerebral palsy,and there are few cases with recurrences.After rehabilitation therapy,the muscle strength of patients with cerebral palsy was significantly improved compared with the previous one.The range of motion was significantly improved after operation,and there is no rebounded in aspect of joint activety in the long-term follow-up.The overall gait of the patient was significant improved.The author thought that selective posterior rhizotomy is effective in improving the motor function of lower limbs in patients with cerebral palsy,and it is worth being spread.However,it has to follow the principle of selecting appropriate cases before surgery,precise operation during operation,and timely and effective rehabilitation treatment after surgery,in order to achieve a better curative effect.