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选择性脊神经后根切断术(SPR手术)治疗脑瘫肢体痉挛,收到明显疗效.目前国内外文献报道其显露方法是切除腰2~5推报,切开硬脊膜,选择性切断神经后根来.为了减少脊柱的损坏,硬脊膜的广泛敞开和术后瘢痕粘逐所引起的脊柱不稳和医源性椎管狭窄,我们在动物解剖实验的基础上采用推板节段开窗选择性神经后根束切断水,治疗儿童脑瘫12例,经6个月~12个月随访,痉挛解除显效率91.6%,下肢功能改善率100%,脊柱无畸形,X残片和CT扫描示脊柱、椎管无异常改变.节段推报开窗,系自L2-S1两侧,切除黄韧带和上1/2椎板,在前后根会合处切开硬脊膜,应用显微器械和技术选择神经后根切断.
Selective posterior rhizotomy (SPR surgery) for the treatment of cerebral palsy limb spasm, received significant effect. Currently reported in the literature reported that its revealing method is to remove the waist 2 ~ 5 push the report, cut the dura, nerve root to selectively cut off. In order to reduce the damage to the spine, the extensive opening of the dura mater and the spinal instability and iatrogenic spinal canal stenosis caused by the postoperative scar adhesion, we used the plate segment to open the window of selective nerves based on animal anatomy experiments The posterior root bundle cut off water and treated 12 children with cerebral palsy. After 6 months to 12 months of follow-up, the effective rate of relieving spasm was 91.6%, the function improvement rate of the lower extremities was 100%, the spine was deformity, the X fragment and CT scan showed the spine and spinal canal No abnormal change. Segment push window, from the L2-S1 on both sides, the removal of the ligamentum flavum and the upper half of the lamina, incision of the dura at the anterior and posterior root junctions, the application of micro-instruments and techniques to select the nerve root cut.