Study Of The Treatment For Lower Extremity Spastic Dysfunction In Hemiplegic Cerebral Palsy

Objective:(1) Using Tread Scan system and lateral camera to assess the change of gait and posture after cutting the L5 spinal root as a donating nerve;(2) To establish rodent model for spastic hemiplegic cerebral palsy after perinatal hypoxic-ischemic brain damage and unilateral sensorimotor restriction;(3) To evaluate the treatment of lower extremity spastic dysfunction after cerebral palsy with contralateral L5 nerve transfer in rats;(4) To compare the efficacy of gastrocnemius recession procedures in cerebral palsy.Methods:(1) After cutting unilateral L5 spinal root, the parameter changes of locomotion and joint kinematics are analyzed with Tread Scan system and lateral camera to evaluate the function of the injured leg;(2) After the perinatal hypoxic-ischemic brain damage and/or unilateral sensorimotor restriction on the newborn rats, the long-lasting spasticity and motor deficit of the involved leg was evaluated;(3) On the rat model of spastic hemiplegic cerebral palsy, the ipsilateral L5 spinal root was cut off, with or without the contralateral L5 nerve transfer, the changes of spasticity and motor deficit were evaluated;(4) Cadaveric model of gastrocnemius tightness is established, and therapeutic efficacy and intrinsic stability of three recession procedures were assessed.Results:(1) After the cut of unilateral L5 root, dysfunction of gait analysis was found at 3 weeks, but without obvious change at 12 weeks;(2) Combining perinatal hypoxic-ischemic brain damage and unilateral sensorimotor restriction can lead long-lasting spasticity and motor deficit;(3) The cut of ipsilateral L5 spinal root can result in temporary release of spasticity, and the contralateral nerve transfer can lead recover of spasticity and motor deficit to some extent;(4) Intramuscular lengthening of gastrocnemius is effective and with better stability.Conclusion:(1) The safety of L5 spinal root is further confirmed as a donating nerve in rat;(2) Perinatal hypoxic-ischemic brain damage and unilateral sensorimotor restriction can mimic spastic hemiplegic cerebral palsy;(3) Contralateral L5 nerve transfer can partially improve the spasticity and motor deficit;(4) Intramuscular lengthening of gastrocnemius is more suitable for equinus deformity with cerebral palsy.