ABSTRACT
Objective To investigate the effect of carotid sympathetic nerve net stripping operation in treating children patients with spastic unilateral cerebral palsy and its effect on motor function.Methods Seventy-six children cases of spastic unilateral cerebral palsy were divided into the control group and observation group.On the basis of routine therapy,the former was treated with type A botulinum toxin,while the latter used the carotid sympathetic nerve netting operation for the treatment.After 6-month treatment,the improvement degree of the Comprehensive Functional Rating Scale of Cerebral Palsy Children,Gross Motor Function Measure(GMFM) score and Ashworth spasm grade were compared between the two groups.Results after 6-month treatment,the improvement degrees of the Comprehensive Functional Rating Scale of Cerebral Palsy Children,GMFM scores and Ashworth spasm grade in the observation group were significantly greater than those in the control group,the difference was statistically significant (P＜0.05).Conclusion The carotid sympathetic nerve net stripping operation in treating children patients with spastic unilateral cerebral palsy has significant effect and is worthy to be popularized in clinic.
ABSTRACT
Objective To investigate the clinical efficacy of L1 -S1 selective posterior rhizotomy (SPR)at the medullary conus level for the treatment of double lower extremities spastic cerebral palsy(CP).Methods A total of 1 09 double lower extremities spastic CP children underwent SPR at the level of medullary consul were selected in the Second Affiliated Hospital of Xinjiang Medical University from October 201 0 to May 201 4.The 4 groups were analyzed in terms of muscle tension and gross motor function of the lower limbs 6 months before and after operation,retrospective-ly.The SPSS 1 7.0 software was used for statistical analysis.Results Patients had different degrees of improvement in gross motor function and reduction of spasticity in all muscle groups of lower limbs after operation.Six months after the operation,the muscular tension of hip flexor,hip adductor,knee flexor and plantar flexors (modified Ashworth spastic scale score)were all improved compared with preoperation (t =1 6.635,27.41 1 ,31 .362,38.81 9,all P <0.01 ).Gross motor function of lower limbs (Gross Motor Function Measure)at 6 months after the operation was significantly im-proved compared with preoperation (51 .97 ±1 2.92 vs 41 .01 ±1 1 .46),and the difference was significant(t =26.67, P <0.01 ).The postoperative complications:intracranial hypotension headache (5 cases,4.59%),postoperative high fever (2 cases,1 .83%),incision fat liquefaction (2 cases,1 .83%),sensory barriers of lower limbs (1 case, 0.92%),and urine obstacles (1 case,0.92%).Conclusions SPR at the level of medullary conus has the advantages of minimal injury,rapid recovery and little influence on the stability of the spine.In addition,the procedure can relieve the spasticity of lower limbs of the CP patients effectively.