Author:
Aquilina Kristian,Graham David,Wimalasundera Neil
Abstract
Selective dorsal rhizotomy (SDR) is a neurosurgical technique developed to reduce spasticity and improve mobility in children with cerebral palsy (CP) and lower extremity spasticity. It involves the selective division of lumbosacral afferent (sensory) rootlets at the conus or at the intervertebral foramina under intraoperative neurophysiological guidance. First described in 1908, early procedures were effective at reducing spasticity but were associated with significant morbidity. Technical advancements over the last two decades have reduced the invasiveness of the procedure, typically from a five-level laminoplasty to a single-level laminotomy at the conus. As practised today, SDR is an effective treatment for young patients with bilateral spastic CP who are rigorously selected for surgery and for whom realistic objectives are set. SDR has therefore re-emerged as a valuable management option for spastic CP. In this article, the authors review the single-level SDR technique and its role in the management of bilateral spastic CP, with particular emphasis on patient selection and outcomes.
Subject
Pediatrics, Perinatology, and Child Health
Reference25 articles.
1. Prevalence and characteristics of children with cerebral palsy in Europe;Surveillance of Cerebral Palsy in Europe (SCPE);Dev Med Child Neurol,2002
2. Stability and decline in gross motor function among children and youth with cerebral palsy aged 2 to 21 years;Hanna;Dev Med Child Neurol,2009
3. Early prognosis for ambulation of neonatal intensive care survivors with cerebral palsy;Watt;Dev Med Child Neurol,1989
4. Die Behandlung spastische Lähmungen durch Resektion hinterer Rückenmarkswurzeln;Foerster;Ergebnisse der Chirurgie und Orthopädie,1911
5. Selective dorsal rhizotomy: long-term experience from Cape Town;Langerak;Child's Nerv Syst,2007
Cited by
56 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献