A selective posterior rhizotomy (SPR) was done for reducing spasticity in 18 patients with cerebral palsy. Based on a standard techniques developed by Fasano (Lumbar SPR) and Heimberger (Cervical SPR), we dissected Ll-Sl dorsal rootlets through
T12, Ll
laminectomy in 10 patients and C5-C8 dorsal rootlets through C5-C7 laminectomy in 8 patients. All the rootlets from each root were electrically stimulated with bipolar electrodes (lsec, lmV-50mV). The muscle responses were observed visually and
recorded
by intraoperative 8-channel electromyography. The rootlets showing abnormal motor responses visually and electromyographically were divided and cut. The patients were accessed preoperatively and postopertaively in terms of clinical, functional,
electrophysiological evaluations. Reduction of spasticity was observed in 9 patients in Lumbar SPR, and 5 patients cervical SPR. Recurrence was seen in 3 patients in Lumbar SPR, and 3 patients in cervical SPR. It was noticed that the masons for
the
bad
outcomes was due to improper division and selection of the rootlets which should be cut. These results was shown that SPR could be effective for treating spasticity in the patients of cerebral palsy and more selective section of the rootlets
based
on
neurophysiologic monitoring during operation might maximize its effectiveness on SPR in the treatment of spasticity.
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