Selective spinal nerve followed by a cut in the treatment of clinical observation of spasticity cerebral palsy
|Beijing University of Traditional Chinese Medicine
|The combination of Chinese and Western clinical medicine
|Upper limb spasticity Cerebral palsy Selective cervicalposterior rhizotomy
Objective:To observe the clinical results of selective cervical posterior rhizotomy in treatment of cerebral palsy (CP) with upper limbs spas t ici ty.Methods:From may2008to june2013, twenty patients (six females, sixteen males; aging8-22years) with spastic CP underwent selective cervical posterior rhizotomy. Guided with the nerve stimulator, choosed fasciculus of low threshold nerve dorsal root and cut off. From the first postoperative day, movement and strength training was given. After two weeks, occupational therapy (OT) was done in patients. Assessments (preoperative and postoperative)included the Modified Ashworth Scale for spasticity, the88items version of Gross Motor Function Measure (GMFM-88), the Fine Motor Function Measure Scale and the Functional Independence Measure (FIM)Results:Ail patients were followed up after6months. Modified Ashworth Scale score(preoperative,2weeks after SPR,6months after SPR) were respectively4.20±0.41,1.50±0.60,1.60±0.59; GMFM-88score (preoperative,6months after SPR) were respectively128.25±24.42171.75±20.85; FMFM score (preoperat ive,6months after SPR) were58.15±9.95,84.80±14.29; FIM score (preoperat ive,6months after SPR) were respectively61.35±16.82,77.45±15.41. There was significant improvement after treatment (P<0.01)Conclusions:Selective cervical posterior rhizotomy is an effective method for the treatment of cerebral palsy (CP) with upper limbs spasticity, which can decrease muscular tension, improve motor function and ability of daily living. On the other hand, the long-term outcomes of this treatment will need to be evaluated in a larger, Long-term clinical observation.