SELECTIVE POSTERIOR LUMBOSACRAL RHIZOTOMY IN TEENAGERS AND YOUNG-ADULTS WITH SPASTIC CEREBRAL-PALSY

The outcome of 30 teenagers and young adults who have had selective posterior lumbosacral rhizotomy cerebral palsy spasticity was analysed. This age group was selected because the full benefits of physiotherapy and maturation of the central nervous system would be likely to have accrued prior to rhizotomy and the post-operative function could be related more directly to the surgery per se. All 30 patients had satisfactory long-term tone reduction, sitting and standing were improved in 21 and 17, respectively, and walking patterns of the 25 of 26 spastic diplegic patients were improved. Five patients had dysaesthetic sensations in their legs and feet, and seven had patchy inconsistent areas of pin-prick loss which persisted for more than 2 years post-operatively. Touch was preserved in all cases and there were no patients with incontinence. Twenty-three patients were unequivocally positive about the benefits of this procedure.