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目的观察选择性脊神经后根切断术(selective posterior rhizotomy,SPR)治疗脑瘫性下肢痉挛的疗效,术中充分利用体架及体位增大腰骶角,保留大部分L5棘突及椎板,选择性切断L5/S1脊神经后根。方法回顾性分析2010年6月~2014年12月41脑瘫患儿例行SPR手术的临床资料,评估临床症状缓解情况。结果随访1年,痉挛状态缓解96.6%,肌张力缓解97.5%,粗大运动功能明显改善(P<0.05)。结论 SPR手术有确切的疗效,能明显改善患儿的粗大运动功能,手术体架的使用,能减少L5附件的破坏。
Objective To observe the curative effect of selective posterior rhizotomy (SPR) on spasticity of lower extremity in the treatment of cerebral palsy. During the operation, full use of lumbar and sacral angle of the body racks and body position retained the majority of L5 spinous processes and lamina, Cut off the dorsal roots of L5 / S1 spinal nerves. Methods The clinical data of routine SPR surgery in children with cerebral palsy from June 2010 to December 2014 were retrospectively analyzed to evaluate the clinical symptom relief. Results One year follow-up, the state of spasticity was relieved by 96.6%, the relaxation of muscle tone was 97.5%, and the function of gross motor was improved obviously (P <0.05). Conclusion SPR surgery has the exact effect, can significantly improve children’s coarse motor function, the use of surgical racks, can reduce the destruction of L5 attachment.