Surgical Outcome and Intraoperative Electrophysiological Monitoring in Selective Posterior Rhizotomy

ABSTRACT

Selective posterior rhizotomy(SPR) has been known to reduce the spasticity as well as to improve the quality of life in patients with intractable spasticity. Twenty patients underwent SPR under intraoperative electrophysiological monitoring (IOM). Fifty-two percent of sacrolumbar rootlet were cut after electrical stimulation. Eighteen patients(90%) with spastic type of cerebral palsy showed marked reduction of spasticity and functional improvement without any complication. The patients who did not respond to SPR had mixed types of spasticity. IOM facilitate the selection of pathological rootlets regardless of anaesthetic level, intensity of electrical stimulation, and individual variability of responses. It is concluded that careful selection of surgical candidates and of pathological rootlets under IOM are important to reduce the spasticity, thereby to obtain a better outcome.