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Information Journal Paper

Title

Case Report: Intraoperative Neurophysiology Monitoring DuringSelective Dorsal Rhizotomy for Spastic Cerebral Palsy

Pages

  117-122

Abstract

 Background and Importance: Selective Dorsal rhizotomy (SDR) is a neurosurgical procedurecurrently used as a surgical treatment of children with spasticity in their legs. In SDR, the dorsalroots from L2 to S1 or S2 is partially sectioned. The primary goal of SDR is to reduce spasticityand improve the range of movement with preservation of muscle strength. The dorsalroots involved in spasticity are identified on the basis of intraoperative electrophysiologicalstimulation. Currently, SDR is most commonly performed for the treatment of Spastic cerebralpalsy in children. Case Presentation: We report an 8-year-old child with spastic cerebral palsy who underwentintraoperative neurophysiology monitoring during SDR for treating his spasticity. Before theoperation, patient’ s examination revealed more spasticity at the lower extremities, mildspasticity 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. Electrophysiologicalmonitoring was initially used to help differentiate between the ventral and dorsal roots andcutting the abnormal sensory rootlets. Conclusion: After the operation, his motor power of the lower extremities in the proximal anddistal muscles was 4 out of 5, his saddle sensation became normal, and there was no urinaryand stool incontinency. Four weeks after the surgery, he could walk about 10 m withouthelp. His examination at 2 and 4 weeks after the operation showed was no sign of sensorydeficits, urinary, or stool incontinency. Two months after the operation, the patient could walkindependently without help while before the operation, he could not.

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    APA: Copy

    SALEHI, SINA, NEMATI, HAMID, & SOLTANI, AHMAD. (2018). Case Report: Intraoperative Neurophysiology Monitoring DuringSelective Dorsal Rhizotomy for Spastic Cerebral Palsy. IRANIAN JOURNAL OF NEUROSURGERY, 4(2 (13)), 117-122. SID. https://sid.ir/paper/351590/en

    Vancouver: Copy

    SALEHI SINA, NEMATI HAMID, SOLTANI AHMAD. Case Report: Intraoperative Neurophysiology Monitoring DuringSelective Dorsal Rhizotomy for Spastic Cerebral Palsy. IRANIAN JOURNAL OF NEUROSURGERY[Internet]. 2018;4(2 (13)):117-122. Available from: https://sid.ir/paper/351590/en

    IEEE: Copy

    SINA SALEHI, HAMID NEMATI, and AHMAD SOLTANI, “Case Report: Intraoperative Neurophysiology Monitoring DuringSelective Dorsal Rhizotomy for Spastic Cerebral Palsy,” IRANIAN JOURNAL OF NEUROSURGERY, vol. 4, no. 2 (13), pp. 117–122, 2018, [Online]. Available: https://sid.ir/paper/351590/en

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