Selective Dorsal Rhizotomy Clinical Analysis Of 85 Cases Of Cerebral Palsy Spastic Effect

Objective:To observe selective posterior rhizotomy treatment efficacy of spastic cerebral palsy.Methods:From September2010to September2011,85cases were treated the spasms and mixed type (mainly spastic) cerebral palsy patients, including54males and31females; youngest was3years old, maximum21years, an average of9.6years68cases of spastic, mixed (spasm mainly associated with athetoid)17cases; preoperative lower extremity muscle tone are grade Ⅲ (Ashworth5of level taxonomy), the knee tendon hyperreflexia65cases, ankle clonus positive in60cases, Babinski sign were found in62; independent walking15cases with the walking or walking motion45, may be crawling25; All line of the SPR, according to the preoperative assessment and limb spasms site, the extent and select cut off the postetiot of the segment and proportion, surgery after statistical cut off bilateral lumbar5sacral1after root60cases; the bilateral L4lumbar5and sacral1in25cases, after the root cut the proportion of30%to50%;①operative time (skin incision to suture end);②amount of bleeding;③postoperative short-term complications;④muscle tension and improve the situation;⑤the ability to walk to improve the situation;⑥gait to improve the situation;⑦pathological reflex change indicators observed.Results:The group of85patients from the end of the skin incision to skin suture shortest time45minutes, the longest90minutes.45-70minutes of52cases,70to90minutes,32cases mean operative time was63minutes; blood loss at least15ml, for example, up to255ml,50ml of less than53cases,50-100ml22,100ml-200ml by8cases of more than200ml of2cases; This group of patients had dizziness, nausea in patients with a total of five cases, a transient urinary retention in6cases,6cases of febrile patients, lower limb muscle weakness, muscle involuntary tremors cases, waist chronic pain patients had lower extremity numbness, three cases; postoperative muscle tension:70cases of grade Ⅰ,10cases of grade Ⅱ,Ⅲ grade3cases, Ⅳ in2cases. Accounted for17.65%of muscle tension is reduced to the level Ⅰ (normal) accounted for82.35%, decreased muscle tone, spasms remission rate of100%; ability to walk after surgery rating of5in45cases, accounting for52.94%of the total;4minutes,32cases, accounting for37.65%of the total;3points in6cases, accounting for0.07%of the total, the total efficiency of about90.66%; were observed after the patients gait in the treatment of85cases,70.6%(60cases) gait improved significantly,21.2%(18) to improve the total efficiency of91.8%; knee tendon hyperref lexia significantly decreased by26cases, the ankle clonus disappeared in66cases, the ankle clonus weakened14cases, Babinski sign positive after all change was negative.Conclusion:Selective postetior rhizotomy (SPR) long-term and effective lifting of limb spasticity reduce muscle tension and improve the limb motor function of patients with cerebral palsy, to create the basis for future care and rehabilitation surgery done properly can reduce the incidence of complications, can improve The the adductor muscle tension caused scissors gait, increased patients walk independently opportunity, remains an important method to reduce muscle tension treatment of spastic cerebral palsy.