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目的观察痉挛型脑瘫患儿选择性限制性脊神经后根切断术(limitedselectiveposteriorrhizotomy,LSPR)后,腰椎稳定性、切除椎板再生及脊柱生长发育情况。方法将125例痉挛型脑瘫患儿根据年龄(<8岁、≥8岁)及手术方式(软组织矫形手术、LSPR手术、软组织矫形+LSPR手术)分组。在手术前、后及随访时,分别摄站立位及动力位腰椎正侧位X线片,测量手术前、后腰骶角、L5S1矢状位椎体位移率等指标。分析比较各组之间及手术前、后各项指标的差异。观察术后切除椎板再生及脊柱生长发育情况。结果(1)软组织矫形手术组手术前、后各项指标差异无统计学意义;(2)LSPR组及软组织矫形+LSPR手术组手术前、后各项指标差异显著;(3)行LSPR手术的<8岁组手术前后各项指标差异有统计学意义,≥8岁组手术前后仅L5S1矢状位椎体位移率差异显著;(4)LSPR术后发现L5S1Ⅰ度滑脱3例(3.90%),脊柱侧凸4例(5.19%,Cobb角15°～34°),腰椎前凸3例(3.90%);(5)LSPR术后见切除椎板部分再生。结论LSPR手术对脑瘫患儿腰椎稳定性有一定影响,但不是惟一的因素。儿童LSPR术后,切除的椎板有再生能力。Lumbar stabilityobservationofchildrenwith cerebralpalsyafterlimitedselectiveposteriorrhizoto-my YANG Chao,WANG Qiu-gen,ZHANG Qiu-lin,etal.Department
Objective To observe the stability of lumbar vertebrae, the regeneration of vertebral lamina and the growth and development of the spine after selective limited posterior rhizotomy (LSPR) in children with spastic cerebral palsy. Methods 125 children with spastic cerebral palsy were divided into groups according to their age (<8 years old, ≥8 years old) and operation mode (soft tissue orthopedic surgery, LSPR surgery, soft tissue orthopedics + LSPR surgery). Before and after surgery and follow-up, respectively, the standing position and power of lumbar positive lateral X-ray film, before and after lumbosacral angle, L5S1 sagittal vertebral body displacement and other indicators. Analysis and comparison between groups and before and after surgery, the differences of the indicators. The resection of the vertebral plate and the growth and development of the spine were observed. Results (1) There was no significant difference in indexes before and after soft tissue orthopedic surgery before and after surgery. (2) There was significant difference between LSPR group and soft tissue orthopedic + LSPR group before and after surgery. (3) There were significant differences in the indexes before and after operation in 8-year-old group. There was significant difference in the displacement rate of only L5S1 sagittal vertebral body before and after operation in 8-year-old group. (3) 3 cases (3.90%) of L5S1- Scoliosis in 4 cases (5.19%, Cobb angle 15 ° ~ 34 °), lumbar lordosis in 3 cases (3.90%); (5) LSPR after resection of the lamina resection. Conclusion LSPR has some effect on lumbar stability in children with cerebral palsy, but it is not the only factor. In children with LSPR, the resected lamina has regenerative capacity. Lumbar stabilityobservationofchildren with cerebralpalsyafterlimitedselectiveposteriorrhizoto-my YANG Chao, WANG Qiu-gen, ZHANG Qiu-lin, etal.Department