Intraoperative Neurophysiology Monitoring During Selective Dorsal Rhizotomy for Spastic Cerebral Palsy
Selective Dorsal Rhizotomy (SDR) is a neurosurgical procedure currently used as a surgical treatment of children with spasticity in their legs. In SDR, the dorsal roots from L2 to S1 or S2 is partially sectioned. The primary goal of SDR is to reduce spasticity and improve the range of movement with...
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| Format: | Article |
| Language: | English |
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Guilan University of Medical Sciences
2018-07-01
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| Series: | Iranian Journal of Neurosurgery |
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| Online Access: | http://irjns.org/browse.php?a_code=A-10-216-1&slc_lang=en&sid=1 |
| _version_ | 1818454471640875008 |
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| author | Sina Salehi Hamid Nemati Ahmad Soltani |
| author_facet | Sina Salehi Hamid Nemati Ahmad Soltani |
| author_sort | Sina Salehi |
| collection | DOAJ |
| description | Selective Dorsal Rhizotomy (SDR) is a neurosurgical procedure currently used as a surgical treatment of children with spasticity in their legs. In SDR, the dorsal roots from L2 to S1 or S2 is partially sectioned. The primary goal of SDR is to reduce spasticity and improve the range of movement with preservation of muscle strength. The dorsal roots involved in spasticity are identified on the basis of intraoperative electrophysiological stimulation. Currently, SDR is most commonly performed for the treatment of spastic cerebral palsy in children. We report an 8-year-old child with spastic cerebral palsy who underwent intraoperative neurophysiology monitoring during SDR for treating his spasticity. Before the operation, patient’s examination revealed more spasticity at the lower extremities, mild spasticity at the upper extremities, and occurrence of fixed contracture of his both ankle joints. Intraoperative neuromonitoring (consisting of motor evoked als, direct nerve root stimulation, and free run electromyography) was performed during the operation. Electrophysiological monitoring was initially used to help differentiate between the ventral and dorsal roots and cutting the abnormal sensory rootlets. After the operation, his motor power of the lower extremities in the proximal and distal muscles was 4 out of 5, his saddle sensation became normal, and there was no urinary and stool incontinency. Four weeks after the surgery, he could walk about 10 m without help. His examination at 2 and 4 weeks after the operation showed was no sign of sensory deficits, urinary, or stool incontinency. Two months after the operation, the patient could walk independently without help while before the operation, he could not. |
| first_indexed | 2024-12-14T21:55:25Z |
| format | Article |
| id | doaj.art-4046657c2a7542a198b8cd40a0da0f9d |
| institution | Directory Open Access Journal |
| issn | 2423-6497 2423-6829 |
| language | English |
| last_indexed | 2024-12-14T21:55:25Z |
| publishDate | 2018-07-01 |
| publisher | Guilan University of Medical Sciences |
| record_format | Article |
| series | Iranian Journal of Neurosurgery |
| spelling | doaj.art-4046657c2a7542a198b8cd40a0da0f9d2022-12-21T22:46:07ZengGuilan University of Medical SciencesIranian Journal of Neurosurgery2423-64972423-68292018-07-0142117122Intraoperative Neurophysiology Monitoring During Selective Dorsal Rhizotomy for Spastic Cerebral PalsySina Salehi0Hamid Nemati1Ahmad Soltani2 Shiraz Neuroscience Research Center, Shiraz University of Medical Sciences, Shiraz, Iran Shiraz Neuroscience Research Center, Shiraz University of Medical Sciences, Shiraz, Iran Department of Neurosurgery, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran Selective Dorsal Rhizotomy (SDR) is a neurosurgical procedure currently used as a surgical treatment of children with spasticity in their legs. In SDR, the dorsal roots from L2 to S1 or S2 is partially sectioned. The primary goal of SDR is to reduce spasticity and improve the range of movement with preservation of muscle strength. The dorsal roots involved in spasticity are identified on the basis of intraoperative electrophysiological stimulation. Currently, SDR is most commonly performed for the treatment of spastic cerebral palsy in children. We report an 8-year-old child with spastic cerebral palsy who underwent intraoperative neurophysiology monitoring during SDR for treating his spasticity. Before the operation, patient’s examination revealed more spasticity at the lower extremities, mild spasticity at the upper extremities, and occurrence of fixed contracture of his both ankle joints. Intraoperative neuromonitoring (consisting of motor evoked als, direct nerve root stimulation, and free run electromyography) was performed during the operation. Electrophysiological monitoring was initially used to help differentiate between the ventral and dorsal roots and cutting the abnormal sensory rootlets. After the operation, his motor power of the lower extremities in the proximal and distal muscles was 4 out of 5, his saddle sensation became normal, and there was no urinary and stool incontinency. Four weeks after the surgery, he could walk about 10 m without help. His examination at 2 and 4 weeks after the operation showed was no sign of sensory deficits, urinary, or stool incontinency. Two months after the operation, the patient could walk independently without help while before the operation, he could not.http://irjns.org/browse.php?a_code=A-10-216-1&slc_lang=en&sid=1Intraoperative neurophysiology monitoringSpastic cerebral palsyDorsal rhizotomy |
| spellingShingle | Sina Salehi Hamid Nemati Ahmad Soltani Intraoperative Neurophysiology Monitoring During Selective Dorsal Rhizotomy for Spastic Cerebral Palsy Iranian Journal of Neurosurgery Intraoperative neurophysiology monitoring Spastic cerebral palsy Dorsal rhizotomy |
| title | Intraoperative Neurophysiology Monitoring During Selective Dorsal Rhizotomy for Spastic Cerebral Palsy |
| title_full | Intraoperative Neurophysiology Monitoring During Selective Dorsal Rhizotomy for Spastic Cerebral Palsy |
| title_fullStr | Intraoperative Neurophysiology Monitoring During Selective Dorsal Rhizotomy for Spastic Cerebral Palsy |
| title_full_unstemmed | Intraoperative Neurophysiology Monitoring During Selective Dorsal Rhizotomy for Spastic Cerebral Palsy |
| title_short | Intraoperative Neurophysiology Monitoring During Selective Dorsal Rhizotomy for Spastic Cerebral Palsy |
| title_sort | intraoperative neurophysiology monitoring during selective dorsal rhizotomy for spastic cerebral palsy |
| topic | Intraoperative neurophysiology monitoring Spastic cerebral palsy Dorsal rhizotomy |
| url | http://irjns.org/browse.php?a_code=A-10-216-1&slc_lang=en&sid=1 |
| work_keys_str_mv | AT sinasalehi intraoperativeneurophysiologymonitoringduringselectivedorsalrhizotomyforspasticcerebralpalsy AT hamidnemati intraoperativeneurophysiologymonitoringduringselectivedorsalrhizotomyforspasticcerebralpalsy AT ahmadsoltani intraoperativeneurophysiologymonitoringduringselectivedorsalrhizotomyforspasticcerebralpalsy |