1. Infra-Conus Single-Level Laminectomy for Selective Dorsal Rhizotomy: Technical Advance.
- Author
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Bales, James, apkon, Susan, Osorio, Marisa, Kinney, Gregory, Robison, R. aaron, Hooper, Erin, and Browd, Samuel
- Subjects
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RHIZOTOMY , *SPINAL nerve root surgery , *SPASTICITY , *MUSCLE diseases , *CEREBRAL palsy treatment - Abstract
Background/Aims: Selective dorsal rhizotomy for spastic cerebral palsy is an effective and well-validated surgical approach. Multiple techniques have been described in the past including multiple laminectomies and a single-level laminectomy at the level of the conus. There is considerable technical challenge involved with a single-level laminectomy approach. Methods: We report here a modification of the single- level laminectomy that selectively analyzes each individual nerve root with electromyography to separate dorsal and ventral nerve roots through comparison of stimulus responses. Results: In 18 children with cerebral palsy who underwent this operation there was a mean improvement in the Modified Ashworth Scale of 2.0 with no reported incidence of muscle weakness, sensory loss, or neurogenic bladder. Conclusion: This approach allows for a modification of selective dorsal rhizotomy through a single-level laminectomy and tailors the selection of nerve root sectioning to the individual patient of interest while still maintaining its effectiveness. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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