Clinical Observation Of Lumbar SPR Combined With Stage â…¡ Orthopedic Surgery In The Treatment Of Lower Extremity Spasm Of Cerebral

In 1978, the main surgery treatment of cerebral palsy (CP) is limb orthopedic operation. But this kind of surgery lead to limb spasm relapse easily, and can’t relieve spasm or reduce muscle tension fundamentally, whose effect is limited. Until 1978, Italian scholar Fasno firstly reported that measuring excitability of the spinal nerve dorsal root with electrical stimulation, and then cutting the nerve root fibers of higher excitability. The clinical effect is significant. Then this surgery was promoted extensively.In 1990, Professor Xu Lin carried out SPR in treatment of spastic CP for the first time in China and Asia; and in 1991, he treated upper limb spasm of CP with the cervical SPR. With 20 years’ development, scientists have studied cerebral palsy surgery more deeply than before; they find comprehensive treatment, including drugs, nerve operation, orthopedic operation, and rehabilitation training can rectify the patients’ abnormal posture and activity, reduce the disability degree, removal or delay the progress of related complications and improve the quality of life of patients effectively, which bring hope to patients themselves and their families.Objective:To investigate clinical curative effect on the treatment of spastic cerebral palsy with the lumbar selective posterior rhizotomy combined with the second phase orthopedic operation.Methods:To retrospectively analyse the clinical data of the 52 cases of patients with cerebral palsy. All cases were divided into group A of 29 patients (3-7-year-old) and group B of 23 cases(over 7-year-old). To observe improvement of limb spasm, plantar flexion deformity, scissors leg deformity, lower limb muscle tension at the 7th day after SPR, before the second phase orthopedic operation and after the second phase orthopedic operation; and the changes of tendon reflex, ankle clonus, pathological syndrome, Holden walking function rating and related symptoms. And then, assess the therapeutic efficacyby statistical analysis of relevant data. (The patient medical records are not unified, so just observing the improvement of muscle tension at the 7th day after SPR)Results:1. The lower limb muscle tension and spasm of two groups were improved continuously after two phase operation in the near future, whose effect improved most significantly at the 7th day after SPR; and group A improved better than group B.2. The tendon reflex, ankle clonus and pathological syndrome of two groups were improved continuously after two phase operation in the near future, whose effect was improved most significantly after SPR; and group A improved better than group B.3. The plantarflexion deformity, scissors leg, deformity and Holden walking function rating of two groups were improved continuously after two phase operation in the near future, whose effect was improved most significantly after the second phase orthopedic operation; and group A improved better than group B.Conclusions:SPR combined the second phase orthopedic operation is safe and effective, which can to reduce muscle tension, relieve spasm, rectify deformity, improve motor function continuously in the near future. It can also relieve upper limb spasticity, and improve strabismus, salivation and dysphonia.Besides,to ensure treatment effect, the patients should insist on formal, systematic rehabilitation training for a long time before and after the operation. In contrast, the optimal treatment age for patients of spastic cerebral palsy with SPR is 3-7-year-old, whose limb spasm and walking function improved more significantly.