单侧锁孔微创椎板间入路选择性脊神经后根切断术在痉挛型偏瘫中的应用.

Objective To evaluate the efficacy and safety of selective posterior rhizotomy ( SPR) through unilateral keyhole microinvasive interlaminar approach in the treatment of spastic hemiplegia of lower limbs. Methods The clinical data of 23 patients with spastic hemiplegia of the lower extremities were randomly grouped and treated by SPR through unilateral keyhole microinvasive interlaminar approach and Peacock surgery, admitted to Department of Neurosurgery, Yuquan Hospital of Tsinghua University from July 2019 to July 2021, were analyzed retrospectively. The patients were followed up for 1 year. The general data, modified Ashworth score ( MAS) and gross motor function classification system score ( GMFCS) before and 1 year after surgery were analyzed. Results All 23 patients completed SPR through unilateral keyhole microinvasive interlaminar approach or Peacock surgery. The scores of MAS and GMFCS were significantly improved after operation and 1 year after the operation. Conclusions Unilateral keyhole microinvasive interlaminar approach provides a good exposure for the spinal nerve roots, the efficacy is as well as Peacock surgery. And SPR through unilateral keyhole microinvasive interlaminar approach causes less damage to the bony structure, preserve the stability of the spine, and does not increase the risk of operation. SPR by this approach has good efficacy and safety. [ABSTRACT FROM AUTHOR]