限制性椎板切除后根切断治疗创伤性痉挛瘫

Posterior Rhizotomy Through a Limited Exposure for Treatment of Traumatic Spasticity

目的 探讨通过仅切除L1椎板行后根切断治疗创伤性痉挛瘫的可行性。方法 本组 16例 ,均为颈胸椎骨折患者。瘫痪程度FrankelB 8例 ,FrankelA 8例。肌张力 4级 (Ashworth) 4例 ,5级 12例。手术均在局麻下进行 ,切除L1椎板可显露L1～S1后根 ,行后根切断术。结果 术后 16例双下肢痉挛基本解除。术前 4例痉挛 4级 ,术后 3例降至 1级 1例 ,降至 0级。术前 12例 5级 ,术后 10例降至 1级 ,2例降至 2级。获随访 12例 ,平均 3 4年 ,解痉效果稳定。结论 通过限制性椎板切除可准确识别各后根 。

Objective To discuss the possibility of posterior rhizotomy through a limited exposure for treatment of traumatic spasticity.Methods Sixteen patients of cervical and thoracic vertebral fracture with Frankel A to B palsy and 4 to 5 grade muscular tension(Ashworth)were processed with posterior rhizotomy through a only L 1 laminectomy.Results All patients spasticity were relieved from 4 to 5 grade down to 0 to 1 grade.Twelve patients were followed with an average 3 4 years.Their results of spastisity relieved were stable.Conclusion The limited laminectomy is enough for the exposure of posterior roots,and is possible for posterior rhizotomy.