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目的:探讨对脑性瘫痪患者实施腰骶脊神经后根交叉吻合后,该脊神经后根支配肌群的肌张力和牵张反射的变化和对下肢功能的影响。方法:选择双侧L3～5和S1脊神经后根兴奋性高的1/3部分切断,并将L3远断端与L5远断端吻合,L4远断端与S1远断端吻合。术后1周、3个月、半年和1年测定下肢肌张力以及牵张反射。结果:术后双下肢肌张力均下降1或2级,Gerard运动功能评级67%(22/33)上升1级,术后1年双下肢不用外力支持可行走>90m者23例,行走能力较术前明显提高12例,高肌张力和牵张反射亢进则有轻度复发。结论:腰骶脊神经后根在腰骶部可行交叉吻合,吻合后脑性瘫痪患者双下肢高肌张力和牵张反射可减弱,双下肢活动功能可得到改善。
OBJECTIVE: To investigate the changes of muscle tone and stretch-reflex of the dorsal root muscle of the dorsal root ganglion and the effects on the function of lower extremities after the lumbosacral spinal nerve root posterior cross anastomosis is performed in patients with cerebral palsy. Methods: One third of the excision of posterior root of L3 ~ 5 and S1 spinal nerves in both sides was cut off. The far end of L3 and distal end of L5 were anastomosed. One week, three months, six months and one year after operation, the lower limb muscle tone and stretch-reflex were measured. Results: The muscle tension of both lower extremities decreased by 1 or 2 postoperatively, and the motor function rating of Gerard increased by 1 grade at 67% (22/33). One year after operation, the lower extremity supported by the lower extremity without external force supported the walkability> 90 m in 23 cases Preoperative significantly increased in 12 cases, high muscle tone and stretch hyperreflexia mild recurrence. Conclusion: The lumbosacral spinal dorsal root of lumbosacral spinal nerve can be cross-matched anastomosed. After anastomosis, the bilateral lower extremity high muscle tone and stretch-reflex can be weakened and the activity of both lower extremities can be improved.