DIFFERENTIATED APPROACH TO THE TREATMENT OF SPASTIC LOWER LIMB SYNDROME
Keywords:
spasticity, cerebral palsy, selective dorsal rhizotomy, selective peripheral neurotomy, intraoperative neuromonitoring, rehabilitation.Abstract
The aim of this study was to validate a differentiated approach to the surgical treatment of lower limb spastic syndromes in children with cerebral palsy (CP) based on clinical and neurophysiological criteria. This prospective study included 75 patients with various forms of CP. Depending on the underlying pathogenetic mechanism and degree of spasticity, they underwent selective dorsal rhizotomy (SDR), selective peripheral neurotomy, or botulinum toxin therapy. Efficacy was assessed using the clinical and functional scales MAS, GMFCS, and MACS, as well as electromyography data. The results demonstrated a more pronounced and persistent reduction in spasticity with surgical interventions compared to conservative methods, particularly with the use of intraoperative neuromonitoring, which ensures the accuracy and safety of the intervention. These study data support the feasibility of individualizing surgical tactics based on a comprehensive clinical and neurophysiological assessment.
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