[Lumbar structural observation of children with cerebral palsy after selective posterior rhizotomy].
OBJECTIVE
To investigate the stability of lumbar column after selective posterior rhizotomy and to observe the healing of exscinded laminae.


METHODS
One hundred and seventy nine children with spastic cerebral palsy were divided into four groups (A, B, C, D) according to the age (< 10 years or > or = 10 years) and walking ability (ambulatory or unable to walk) and were operated on by selective posterior rhizotomy (SPR). Lumbar X-ray films, both standing and lying position, and orthotopic and lateral dynamic lumbar films were taken pre- and postoperatively. Lumbosacral angle, Cobb's angle in lateral position, and AO/W, RO/W of dynamic films were recorded and analyzed according to Posner's definition. Regeneration of exscinded laminae was observed.


RESULTS
(1) The lumbosacral angle, Cobb's angle, and other indicators in the ambulatory group (A + C) were not significantly varied pre- and postoperatively; (2) The lumbo-sacral angle, Cobb's angle, and other indicators in the groups unable to walk independently (B + D groups) were varied significantly. (3) Nine cases of scoliosis (with the Cobb's angle of 18 degrees-35 degrees) were found in the group of 10 years younger (9.38%); (4) Six cases of spondylolysis (7.23%, with Cobb's angle of 15 degrees-25 degrees) and 5 cases of spondylolisthesis (6.58%) were found in the group of 10 years older. (5) Osteous healing of sectioned laminae was found in the group of age younger than 10 years, especially in the young children. (6) Stability of lumbar vertebrae were not significantly varied pre- and post-operatively among all groups.


CONCLUSIONS
The exscinded laminae of children after SPR have the healing ability. The stability of lumbar column was not significant varied pre- and postoperatively.
Yi
B
B
Orthopaedic Neurology Unit, People's Hospital, Peking University, Beijing 100034, China.
Xu
L
L
Hong
Y
Y
D000293:Adolescent; D002547:Cerebral Palsy / Q000209:etiology* / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000503:physiopathology*; D008297:Male; D011183:Postoperative Complications; D019051:Rhizotomy / Q000009:adverse effects*