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目的探讨脊髓圆锥部选择性脊神经前、后根切断术治疗痉挛性脑瘫的疗效。方法１９９４－１９９８年在脊髓圆锥部进行选择性脊神经后根切断术（ＳＰＲ）的同时进行选择性脊神经前根切断术（ＳＡＲ）治疗痉挛性脑瘫２８例。并选１０例双下肢痉挛性脑瘫患者作同体两侧肢体不同方法治疗对照，右侧行ＳＰＲ＋ＳＡＲ手术，左侧仅行ＳＰＲ手术。结果脊髓圆锥部手术较腰骶部传统术式具有切口小、创伤小、出血少、操作简捷、手术时间短和并发症少等优点。按刘小林疗效评价标准评价，ＳＰＲ＋ＳＡＲ手术解除痉挛效果明显优于单纯ＳＰＲ手术。结论脊髓圆锥部手术是一简捷、安全、可靠、值得提倡的术式，ＳＡＲ手术作为ＳＰＲ手术的补充很有临床价值。
Objective To investigate the therapeutic effect of selective anterior spinal cord and posterior rhizotomy on spastic cerebral palsy in conus medulla oblongata. Methods Selective posterior rhizotomy (SAR) was performed in 28 patients with spastic cerebral palsy during selective spinal nerve root posterior rhizotomy (SPR) in the conus of the spinal cord from 1994 to 1998. Ten patients with spastic cerebral palsy on both lower extremities were treated with different methods on both sides of the body. SPR + SAR was performed on the right and SPR was performed on the left. Results Compared with the traditional operation of the lumbosacral region, the spinal conus surgery has the advantages of small incision, less trauma, less bleeding, simple operation, shorter operative time and fewer complications. Evaluation by Liu Xiaolin efficacy evaluation criteria, SPR + SAR surgery to relieve spasticity was significantly better than simple SPR surgery. CONCLUSIONS: Condylar spinal surgery is a simple, safe and reliable surgical procedure that is worth promoting. SAR surgery is of great clinical value as a supplement to SPR.