Chronic Spinal Cord Stimulation in the Treatment of Cerebral and Spinal Spasticity
Chronic Spinal Cord Stimulation in the Treatment of Cerebral and Spinal Spasticity
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DOI：
10.1159/000368905
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发表时间：
2015-01-01
影响因子：
1.7
通讯作者：
Salova, Ekaterina M.
中科院分区：
文献类型：
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作者：
Dekopov, Andrey V.;Shabalov, Vladimir A.;Salova, Ekaterina M.
目的：本研究的目的是评估脊髓刺激（SCS）对不同组的不同来源的痉挛患者的有效性。材料和方法：对 71 名患者使用 SCS 方法的回顾性研究。患者群体被分为两组：52 名脑瘫 (CP) 病例和 19 名被诊断为脊髓损伤引起的痉挛的患者。平均年龄分别为7.14±4.06岁和35.68±12.42岁。 CP组包括截瘫41例、四肢瘫痪11例。将一个四极电极植入到 Th10-Th12 水平的后硬膜外腔中，并以标准方式放置植入式脉冲发生器（Itrel3，Medtronic）。我们每天进行 3-5 次刺激课程；每次持续30分钟。刺激参数如下：频率100-130 Hz，脉冲宽度120-300 ms，幅度1.5-4 V。随访2至9年。结果：脊柱痉挛患者组的所有病例均观察到肌张力下降：Ashworth 量表从术前 3.71 +/- 0.61 降至术后 2.26 +/- 0.56（p < 0.001）。在脑痉挛组中，仅在痉挛性下肢轻瘫患者中观察到肌张力显着下降：从术前的 3.36 +/- 0.41 降至术后的 1.97 +/- 0.91（p
Objectives: The aim of this investigation is to assess the effectiveness of spinal cord stimulation (SCS) in different groups of patients with spasticity of different origin. Materials and Methods: A retrospective study of the use of the method of SCS in 71 patients. The patient population was divided into two groups: 52 cerebral palsy (CP) cases and 19 patients diagnosed with spasticity caused by spinal injury. The mean age was 7.14 4.06 and 35.68 12.42 years, respectively. The CP group included 41 cases of paraparesis and 11 cases tetraparesis. One quadripolar electrode was implanted into the posterior epidural space at Th10-Th12 level and an implantable pulse generator (Itrel3, Medtronic) was placed in a standard fashion. We performed 3-5 stimulation sessions per day; each lasted 30 min. The stimulation parameters were as follows: rate 100-130 Hz, pulse width 120-300 ms, amplitude 1.5-4 V. The follow-up ranged from 2 to 9 years. Results: Decrease in muscle tone was observed in all cases in the group of patients with spinal spasticity: from 3.71 +/- 0.61 on the Ashworth scale before the operation to 2.26 +/- 0.56 after the operation (p < 0.001). In the group of cerebral spasticity a significant decrease in muscle tone was observed only in patients with spastic lower paraparesis: from 3.36 +/- 0.41 before the operation to 1.97 +/- 0.91 after the operation (p