[Selective cervical dorsal root cutting off part of the vertebral lateral mass fixation combined with exercise therapy for treating spastic cerebral paralysis of the upper limbs caused by cerebral palsy].
OBJECTIVE
To explore the feasibility and the result for the surgical treatment of spastic cerebral paralysis of the upper limbs in patients who underwent the selective cervical dorsal root cutting off part of the vertebral lateral mass fixation combined with exercise therapy.


METHODS
From March 2004 to April 2008, 27 patients included 19 boys and 8 girls, aging 13-21 years with an average of 15 years underwent selective cervical dorsal root cutting off part of the vertebral lateral mass fixation with exercise therapy. The AXIS 8 holes titanium plate was inserted into the lateral mass of spinous process through guidance of the nerve stimulator, choosed fasciculus of low-threshold nerve dorsal root and cut off its 1.5 cm. After two weeks, training exercise therapy was done in patients. Training will include lying position, turning body, sitting position, crawling, kneeling and standing position, walking and so on. Spastic Bobath inhibiting abnormal pattern was done in the whole process of training. The muscular tension, motor function (GMFM), functional independence (WeeFIM) were observed after treatment.


RESULTS
All patients were followed up from 4 to 16 months with an average of 6 months. Muscular tension score were respectively 3.30 +/- 0.47 and 1.25 +/- 0.44 before and after treatment;GMFM score were respectively 107.82 +/- 55.17 and 131.28 +/- 46.45; WeeFIM score were respectively 57.61 +/- 25.51 and 87.91 +/- 22.39. There was significant improvement before and after treatment (P < 0.01).


CONCLUSIONS
Selective cervical dorsal root cutting off part of the vertebral lateral mass fixation combined with exercise therapy was used to treat spastic cerebral paralysis of the upper limbs is safe and effective method, which can decrease muscular tension and improve motor function, which deserves more wide use.
Zhang
Peng
P
Department of Orthopaedics, Dongzhimen Hospital, Beijing University of Traditional Chinese Medical, Beijing 100700, China.
Hu
Wei
W
Cao
Xu
X
Xu
Shi-gang
SG
Li
De-kui
DK
Xu
Lin
L
D000293:Adolescent; D001132:Arm / Q000503:physiopathology*; D002547:Cerebral Palsy / Q000150:complications*; D002574:Cervical Vertebrae / Q000601:surgery*; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008297:Male; D009128:Muscle Spasticity / Q000209:etiology / Q000503:physiopathology / Q000601:surgery* / Q000628:therapy; D010243:Paralysis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery* / Q000628:therapy; D013126:Spinal Nerve Roots / Q000601:surgery*; D055815:Young Adult