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目的 :探讨脑性瘫痪外科治疗的不同手术方法及腰骶神经根兴奋性与肌肉痉挛的关系。方法 :采用脑立体定向术和高选择性脊神经背根切断术治疗 6 4例痉挛型脑瘫患者 ,并对 12例L2 ～S14 0 8根感觉根小束进行兴奋阈值测定。结果 :脑立体定向术组手术有效率 81 3% ,脊神经背根切断术组术后肌痉挛明显缓解 ,两种手术均无严重并发症和死亡病例。各节段脊小束兴奋阈高低不均 ,但传导潜伏期值在正常范围。结论 :高选择性脊神经背根切断术是脑性瘫痪最有效方法之一 ,手术通过减少背根传入纤维的异常兴奋性而缓解肌痉挛
Objective: To explore the different surgical methods of surgical treatment of cerebral palsy and lumbosacral nerve root excitability and muscle spasm. Methods: Sixty-four patients with spastic cerebral palsy were treated with stereotaxy and high-selective dorsal rhizotomy. The excitatory thresholds were measured in 12 patients with L2-S14 08 sensory root bundle. Results: The effective rate of operation in stereotaxic surgery group was 81.3%. The postoperative muscle spasm of spinal dorsal rhizotomy group was relieved obviously. There was no serious complication and death in either operation. The excitatory threshold of each segment ridge was uneven, but the conduction latency was within the normal range. CONCLUSIONS: Highly selective spinal dorsal root rhizotomy is one of the most effective methods of cerebral palsy. Surgery relieves muscle spasms by reducing the abnormal excitability of dorsal root afferent fibers