Document Detail

Selective posterior rhizotomy in the treatment of cerebral palsy, first experience in Czech Republic.
MedLine Citation:
PMID:  12839212     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Selective posterior rhizotomy (SPR) is a surgical treatment of spasticity in patients with cerebral palsy (CP). STARTING POINT: We present the first experience with SPR in Czech Republic. MATERIAL AND METHODS: 14 patients with severe spasticity were indicated for SPR during the period of 2 years (2001-2002). The indication criteria were severe spasticity with clonus, more or less symmetric impairment of lower extremities and increased H/M ratio in preoperative electromyography. SPR was performed in 13 cases, in one patient only the revision and intradural neurolysis of caudal roots was done. In all patients we used osteoplastic laminotomy L2-S1. The intraoperative EMG monitoring with selection of rootlets with abnormal response was performed. Preoperative and postoperative number of spasms, passive range of joint movements, Ashworth scale, Peacock grade and level of functional independence were assessed. The comparison of H/M ratio on EMG before and after surgery was performed. RESULTS: An evident improvement in all tested parameters was noted. The per-operative course in all cases was uneventful. Till now, no persistent complications have been observed. CONCLUSION: SPR improves functional ability in a selected group of CP patients. Our findings regarding clinical outcomes are in agreement with those of other authors. In our experience the extrapyramidal symptoms may not be an absolute contraindication of SPR. (Tab. 5, Fig. 3, Ref. 10.).
M Tichy; J Kraus; D Horinek; M Vaculik
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Bratislavské lekárske listy     Volume:  104     ISSN:  0006-9248     ISO Abbreviation:  Bratisl Lek Listy     Publication Date:  2003  
Date Detail:
Created Date:  2003-07-03     Completed Date:  2003-07-22     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0065324     Medline TA:  Bratisl Lek Listy     Country:  Slovakia    
Other Details:
Languages:  eng     Pagination:  54-8     Citation Subset:  IM    
Department of Neurosurgery, University Hospital Motol, 2nd Faculty of Medicine, Charles University, Prague, Czech Republic.
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MeSH Terms
Cerebral Palsy / surgery*
Monitoring, Intraoperative
Muscle Spasticity / physiopathology,  surgery*

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