Selective dorsal rhizotomy: meta-analysis of three randomized controlled trials

被引：185

作者：

McLaughlin, J

Bjornson, K

Temkin, N

Steinbok, P

Wright, V

Reiner, A

Roberts, T

Drake, J

O'Donnell, M

Rosenbaum, P

Barber, T

Ferrel, A

机构：

[1] Childrens Hosp & Med Ctr, Seattle, WA 98105 USA

[2] Childrens & Womens Hlth Ctr, Vancouver, BC, Canada

[3] Bloorview MacMillan Ctr, Toronto, ON, Canada

[4] Hosp Sick Children, Toronto, ON M5G 1X8, Canada

[5] Univ Washington, Seattle, WA 98195 USA

来源：

DEVELOPMENTAL MEDICINE AND CHILD NEUROLOGY | 2002年 / 44卷 / 01期

关键词：

D O I：

10.1017/S0012162201001608

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

This study is a comparative analysis and meta-analysis of three randomized clinical trials. Children with spastic diplegia received either 'selective' dorsal rhizotomy (SDR) plus physiotherapy (SDR+PT) or PT without SDR (PT-only). Common outcome measures were used for spasticity (Ashworth scale) and function (Gross Motor Function Measure [GMFM]). Baseline and 9- to 12-month outcome data were pooled (n=90). At baseline, 82 children were under 8 years old and 65 had Gross Motor Function Classification System level II or III disability. Pooled Ashworth data analysis confirmed a reduction of spasticity with SDR+PT (mean change score difference -1.2; Wilcoxon p<0.001). Pooled GMFM data revealed greater functional improvement with SDR+PT (difference in change score +4.0, p=0.008). Multivariate analysis in the SDR+PT group revealed a direct relationship between percentage of dorsal root tissue transected and functional improvement. SDR+PT is efficacious in reducing spasticity in children with spastic diplegia and has a small positive effect on gross motor function.

引用

页码：17 / 25

页数：9

共 40 条

[1]

ABBOTT R, 1993, NEUROSURGERY, V33, P851

[2] NEUROSURGICAL TREATMENT OF SPASTICITY - SELECTIVE POSTERIOR RHIZOTOMY AND INTRATHECAL BACLOFEN [J].

ALBRIGHT, AL .

STEREOTACTIC AND FUNCTIONAL NEUROSURGERY, 1992, 58 (1-4) :3-13

[3] INTERRATER RELIABILITY OF A MODIFIED ASHWORTH SCALE OF MUSCLE SPASTICITY [J].

BOHANNON, RW ;

SMITH, MB .

PHYSICAL THERAPY, 1987, 67 (02) :206-207

[4]

BUTLER P, 1984, DEV MED CHILD NEUROL, V26, P607

[5] HOW SELECTIVE IS SELECTIVE POSTERIOR RHIZOTOMY [J].

COHEN, AR ;

WEBSTER, HC .

SURGICAL NEUROLOGY, 1991, 35 (04) :267-272

[6]

Gage JR., 1991, Gait Analysis in Cerebral Palsy

[7]

Grether J K, 1992, Paediatr Perinat Epidemiol, V6, P339, DOI 10.1111/j.1365-3016.1992.tb00774.x

[8]

Haley SM, 1991, PEDIATRIC PHYSICAL T, V3, P177

[9]

Hays RM, 1998, DEV MED CHILD NEUROL, V40, P233

[10]

Hays RM, 1997, MENT RETARD DEV D R, V3, P168, DOI 10.1002/(SICI)1098-2779(1997)3:2<168::AID-MRDD8>3.0.CO

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