Surgical treatment of spasticity in children: comparison of selective dorsal rhizotomy and intrathecal baclofen pump implantation
Surgical treatment of spasticity in children: comparison of selective dorsal rhizotomy and intrathecal baclofen pump implantation
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DOI：
10.1007/s00381-007-0457-8
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发表时间：
2008-02-01
影响因子：
1.4
通讯作者：
Kestle, John
中科院分区：
文献类型：
--
作者：
Kan, Peter;Gooch, Judith;Kestle, John
儿童痉挛的神经外科治疗包括传统的选择性背根切断术（SDR）和鞘内巴氯芬泵（ITBPs），在过去的十年中已被广泛使用，作为一种有吸引力的替代方案。本研究的目的是检查和比较这两个程序在治疗儿童严重spasticity.Materials和方法一个连续系列的71名儿童谁接受SDR治疗痉挛进行了比较，一组71名儿童匹配的年龄和术前评分的粗大运动功能分类系统（GMFCS）谁接受ITBP安置。GMFCS评分的变化，下肢张力（基于修改后的Ashlove-Bohannon量表），和下肢被动活动范围（PROM）在1年，以及需要后续的矫形程序和父母的满意度被选为结果measures.Results在1年，SDR和ITBP降低张力，增加PROM，并改善功能。两种手术均获得了高度的患者满意度。与ITBP相比，SDR提供了更大幅度的音调改善（-2.52 vs-1.23，p
Introduction Neurosurgical treatments for spasticity in children include the traditional selective dorsal rhizotomy (SDR) and intrathecal baclofen pumps (ITBPs), which have been widely used in the past decade as an attractive alternative. The purpose of the study was to examine and compare the outcomes of these two procedures in the treatment of children with severe spasticity.Materials and methods A consecutive series of 71 children who underwent SDR for treatment of spasticity was compared with a group of 71 children matched by age and preoperative score on the Gross Motor Function Classification System (GMFCS) who underwent ITBP placement. Change in GMFCS score, lower-extremity tone (based on the Modified Ashworth-Bohannon Scale), and lower-extremity passive range of movement (PROM) at 1 year as well as the need for subsequent orthopedic procedures and parents' satisfaction were selected as outcome measures.Results At 1 year, both SDR and ITBP decreased tone, increased PROM, and improved function. Both procedures resulted in a high degree of patient satisfaction. Compared with ITBP, SDR provided a larger magnitude of improvement in tone (-2.52 vs -1.23, p