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- Title
Infra-Conus Single-Level Laminectomy for Selective Dorsal Rhizotomy: Technical Advance.
- Authors
Bales, James; apkon, Susan; Osorio, Marisa; Kinney, Gregory; Robison, R. aaron; Hooper, Erin; Browd, Samuel
- Abstract
Background/Aims: Selective dorsal rhizotomy for spastic cerebral palsy is an effective and well-validated surgical approach. Multiple techniques have been described in the past including multiple laminectomies and a single-level laminectomy at the level of the conus. There is considerable technical challenge involved with a single-level laminectomy approach. Methods: We report here a modification of the single- level laminectomy that selectively analyzes each individual nerve root with electromyography to separate dorsal and ventral nerve roots through comparison of stimulus responses. Results: In 18 children with cerebral palsy who underwent this operation there was a mean improvement in the Modified Ashworth Scale of 2.0 with no reported incidence of muscle weakness, sensory loss, or neurogenic bladder. Conclusion: This approach allows for a modification of selective dorsal rhizotomy through a single-level laminectomy and tailors the selection of nerve root sectioning to the individual patient of interest while still maintaining its effectiveness.
- Subjects
RHIZOTOMY; SPINAL nerve root surgery; SPASTICITY; MUSCLE diseases; CEREBRAL palsy treatment
- Publication
Pediatric Neurosurgery, 2016, Vol 51, Issue 6, p284
- ISSN
1016-2291
- Publication type
Article
- DOI
10.1159/000448046