[Complications of selective posterior rhizotomy for lower limb spasticity of cerebral palsy].
Słowa kluczowe
Abstrakcyjny
OBJECTIVE
To investigate the complications of spastic cerebral palsy with selective posterior rhizotomy (SPR).
METHODS
In the study, 2 593 patients who had undergone SPR from January 2000 to September 2012 were followed-up for at least one year. The complications were classified.
RESULTS
Peri-operative complications: pulmonary system complications including bronchial spasm (5 cases, 0.19%) and aspiration pneumonia (4 cases, 0.15%); digestive system complications including abdominal bloating (145 cases, 5.6%) and colic (80 cases, 3.1%); urinary system complications including temporary bladder dysfunction (54 cases, 2.1%) and urinary tract infection (6 cases, 0.23%); peripheral nervous system complications including lower extremity weakness (327 cases, 12.6%) and lower extremity sensory disturbances (140 cases, 5.4%); central nervous system complications including headache (112 cases, 4.3%) and epileptic seizures (4 cases, 0.15%). None spinal or intracranial infection, intraspinal hematoma or intracranial hemorrhage were identified. General surgery complications including back pain (1 382 cases, 53.3%), delay wound healing caused by infection (5 cases, 0.19%) and cerebrospinal fluid leakage (8 cases, 0.31%). Long-term follow-up complications including lower limb decreased exercise capacity (incidence: 7.33%) and lower extremity sensory disturbance (incidence: 5.59%). Urination occurred in only one case and defecation function disturbance with no sexual dysfunction was identified. The incidences of scoliosis, thoracic kyphosis, spondylolisthesis and long-term back pain were 7.23% (31/429), 4.2% (18/429), 10.49% (45/429) and 9.72% respectively.
CONCLUSIONS
SPR is one of the effective and safe surgical treatments for spastic cerebral palsy. Valid methods should be applied to reduce the incidence of postoperative complications, such as choosing the appropriate patients, meticulously operating in the surgery, assistance of electrophysiological guidance, reinforcing perioperative management and regular rehabilitation training after operation.
