Abstract:
In the last decade there has been incredible interest and advancement in the surgical care of adult patients with upper motor neuron (UMN) injuries. Spasticity represents a prevalent and debilitating feature of UMN syndrome, which can result from cerebral palsy, spinal cord injury, cerebrovascular accident and traumatic or anoxic brain injury. While several diagnostic tools and management strategies have been described for upper limb spasticity, evidence-based practice guidelines do not currently exist due to low patient volume and a paucity of surgeons routinely performing surgeries in UMN syndrome patients. As such, expert consensus may help provide guidance for patients, therapists and clinicians alike. In this article an expert panel was assembled, and the Delphi method was utilized to present diagnostic considerations, define operative indications, discuss surgical treatment modalities and encourage a standard set of outcome measures for patients with upper extremity spasticity.
摘要:
在过去的十年中,对上运动神经元(UMN)损伤的成年患者的手术护理产生了令人难以置信的兴趣和进步。痉挛代表了UMN综合征的一个普遍和衰弱的特征,这可能是脑瘫导致的,脊髓损伤,脑血管意外和创伤性或缺氧脑损伤。虽然已经描述了上肢痉挛的几种诊断工具和管理策略,目前尚不存在基于证据的实践指南,原因是患者体量低,且缺乏对UMN综合征患者进行常规手术的外科医生.因此,专家共识可能有助于为患者提供指导,治疗师和临床医生都一样。在本文中,一个专家小组被召集起来,德尔菲法被用来提出诊断考虑因素,定义操作指示,讨论上肢痉挛患者的手术治疗方式,并鼓励一套标准的预后措施。