选择性坐骨神经分支部分切断术治疗膝关节屈曲痉挛

Selective Sciatic Neurotomy for Relief of Spasticity Focalized to the Knees Flexors

目的探讨选择性坐骨神经分支部分切断术治疗膝关节屈曲痉挛的效果。方法回顾分析2000年2月至2001年11月手术治疗的33例共计44侧膝屈曲痉挛状态的病人资料,所有病人均采用选择性坐骨神经分支部分切断术治疗。结果全部病人平均随访11.6个月。所有病人术后立即感膝部痉挛状态缓解,随访期间缓解率为91%(30/33)。术后2周内步态功能均有改善,随访期间改善者为87.88%(29/33)。生活质量在随访期间所有病人均有提高。术后发生小腿感觉障碍5例,随访期间3例完全恢复,2例部分恢复。无1例发生严重肌无力。结论选择性坐骨神经分支部分切断术是治疗膝关节屈曲痉挛安全有效的方法。

Objective To study the effect of selective sciatic neurotomy on relief of the spasticity focalized to the knees flexors.Methods Data of33patients with spasticity focalized to the44knees flexors who were microsurgically treated by selective sciatic neurotomy from February2000to November2001were analyzed retospectively.Results All the patients were averagely followed up for11.6months.The knee spasm were relieved in the33patients immediately after the operation and in30patients(90%)during the follow-up.The gait was improved in all the patients within2weeks after the operation and in29patients(87.88%)during the follow-up.The quality of life was better in all the patients during the follow-up.The dysesthesia of legs occurred in the5patients after the operation.The obvious muscle weakness wasn't found out in all the cases.Conclusions The selective sciatic neurotomy is an effective and safe microsurgical method for the treatment of spasticity focalized to knee flexors.