Long-Term Outcome of Selective Dorsal Rhizotomy for Spastic Children.

Nelleke G Langerak, Berendina E Veerbeek, Robert P Lamberts
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Abstract

Given the concerns associated with the ageing process in adults with cerebral palsy (CP) and the significant number of children who have undergone selective dorsal rhizotomy (SDR) in the recent decades, there is an important clinical need to evaluate both the short- and long-term impacts of this invasive and irreversible neurosurgical procedure. To gain insight in the health condition, the International Classification of Functioning, Disability and Health (ICF) model was used. The ICF serves as a biopsychosocial model for evaluating individuals with disabilities, providing a comprehensive perspective that encompasses understanding both the 'body structure and function' of individuals and determining the level of 'activity and participation' within the community. Furthermore, this review incorporates the dimension 'quality of life' as an essential factor to be discussed in relation to the outcomes of SDR. Based on a narrative literature review, this chapter outlines the outcomes observed at 5-15 years and 15-25 years post-SDR. Additionally, insights into outcomes beyond 25 years after SDR have been provided, drawing on the experiences of the Cape Town research group in South Africa, where SDR was reintroduced on a large scale by Warwick Peacock in the 1980s. The chapter concludes with a discussion on complications following SDR. This review will provide the clinical community and parents with information about the short- and long-term outcomes of this neurosurgical intervention.

选择性背根切断术治疗痉挛儿童的远期疗效。
考虑到成人脑瘫(CP)患者的衰老过程以及近几十年来大量接受选择性背根切开术(SDR)的儿童的担忧,评估这种侵入性和不可逆神经外科手术的短期和长期影响是一个重要的临床需要。为了深入了解健康状况,使用了国际功能、残疾和健康分类(ICF)模型。ICF作为评估残疾个体的生物心理社会模型,提供了一个全面的视角,包括理解个人的“身体结构和功能”,并确定社区内的“活动和参与”水平。此外,本综述将“生活质量”维度作为与SDR结果相关的基本因素加以讨论。基于叙述性文献综述,本章概述了sdr后5-15年和15-25年观察到的结果。此外,根据南非开普敦研究小组的经验,本文还提供了对SDR引入25年后的结果的见解。上世纪80年代,沃里克•皮科克在南非大规模重新引入了SDR。本章最后讨论了SDR的并发症。本综述将为临床社区和家长提供有关这种神经外科干预的短期和长期结果的信息。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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