Scope of this book is to disseminate dorsal rhizotomy for treating children with disabling, intractable spasticity caused by various pathologies. The volume is composed of five sections. The first section describes history and neuroanatomical background of dorsal rhizotomy and spasticity, while the second one is about the selection and pre-operative evaluation of surgical candidates. The third section is the key for readers who are going to learn this surgical procedure, and describes the various types of surgical procedures and the intraoperative neurophysiology used in the surgery. The fourth section is focused on postoperative rehabilitation, functional evaluation and long-term outcome after dorsal rhizotomy. The last section d describes the future perspective of this technique and explains how to start up a rhizotomy team.
Since the concern about dorsal rhizotomy has been re-emerging recently, this publication is highly expected and will be useful for both beginners in rhizotomy and experienced neurosurgeons.
Introduction.- History of Dorsal Rhizotomy for Spasticity.- Neurophysiological and Neuroanatomical Background of Spasticity. Surgical implication for Dorsal Rhizotomy in Cerebral Palsy.- Role of dorsal rhizotomy in the comprehensive management of childhood spasticity.- Creating a Selective Dorsal Rhizotomy team.- Selection of children with spasticity other than cerebral palsy- Indications, long-term outcome, and exclusion criteria.- Preoperative Assessments for Selective Dorsal Rhizotomy.- Rhizotomy surgery at the conus medullaris.- Cauda equina level Selective Dorsal Rhizotomy.- Rootlet Selection by Crescendo Single-pulse Evoked Compound Muscle Action Potential Interpretation During Selective Dorsal Rhizotomy.- Dorsal Rhizotomy at the Intradural Juxtaforaminal Zone.- Selective dorsal rhizotomy: what, when and why to cut.- Functional posterior rhizotomy with the use of intraoperative neurophysiology.- Postoperative functional recovery and rehabilitation following Selective Dorsal Rhizotomy.- LONG-TERM OUTCOME OF SELECTIVE DORSAL RHIZOTOMY FOR SPASTIC CHILDREN.- Patient Selection in Selective Dorsal Rhizotomy (SDR).- Start-up of Rhizotomy Program in a Developing Country.- New developments in the surgery for spasticity.
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