Analysis Of The Medium-and Long-term Effect Of Open-door Laminoplasty Selective Posterior Rhizotomy On Spastic Cerebral Palsy

Objective:This study is to assess the efficacy of the treatment and the influence on the spine after the open-door laminoplasty selective posterior rhizotomy(ODLSPR) on spastic cerebral palsy.Materials and methods:The subjects studied were the patients with spastic cerebral palsy,who had undergone ODLSPR in the First Affiliated Hospital of Bengbu Medical College from1997to2008. And we adopted the method of retrospective analysis to evaluate the patients’ muscle tone, muscle strength, ambulatory function, as well as whether it is secondary to the spinal deformity and other complications.The information was collected through reviewing the medical records and interviewing the patients through physical examination and inquiry.Results:There were27patients whose mean age at surgery was10.13years; the mean follow-up duration was9.63years. The higher muscle tone of all patients were declined in different degrees. The status of toe steps and crossing-feet were disappeared without recurrence for a long time. Sthenic knee jerk were eliminated but there were several patients also keeping the active knee jerk. Ankle clonus was eliminated in78.57%of all the patients. Babinski’s sign turned to negative in70.45%of the27patients. And the ambulatory function of all patients was improved in different degrees. The postoperative weight-bearing radiographs of all patients were obtained, and1patient had the mild lumbar scoliosis with10℃cobb angles while2patients had the lumbar hyperlordosis. No spondylolysis and spondylolisthesis was visible on the postoperative radiographs. Conclusions:SPR is highly effective in decreasing the muscle tone and improving the motor function without recurrence. SPR via open-door laminoplasty can reconstructed the anatomical structures of the spine and decline the incidence of the spinal deformity significantly which is related to the surgery.