Abstract:

BACKGROUND: Selective posterior rhizotomy (SPR) has been widely used in the treatment of spastic cerebral palsy. Traditionally, total resection of lamina of L1 or L1+T12 at the level of conus is the main method to expose the spinal canal. This method has the potential to cause major damage to the normal anatomical structures of the lumbar spine, resulting in deformity of the spine in the long term.
OBJECTIVE: To evaluate the replantation of lamina and mini-plate fixation and its clinical results in patients with spastic cerebral palsy treated with SPR.
METHODS: Twenty-nine cases with spastic cerebral palsy were treated operatively with SPR from January 2008 to January 2011, accomplished with the replantation of lamina on site and mini-plate fixation after the corresponding segments were completely intercepted by the swing saw. Muscular tension of the lower extremities was observed pre- and post-operatively. X-ray films and CT images were used to observe the status of fusion, stability and shape of the vertebral canal.
RESULTS AND CONCLUSION: All the patients were followed-up, the average reduction of Ⅱ-Ⅲ grade of muscular tension was observed in most patients. The replanted lamina got bony fusion without spinal stenosis or spinal instability at the last follow-up. SPR is an effective therapy for spastic cerebral palsy. After widely exposure of the spinal canal, the method of spinal reconstruction can provide good clinical results for patients treated with SPR. It can avoid compression owing to scar and maintain the spinal integrity.