medecolМедицина и экологияMedicine and ecology2305-60452305-6053Карагандинский медицинский университет10.59598/ME-2305-6053-2026-120-3-30-41medecol-1367Research ArticleОБЗОРЫ ЛИТЕРАТУРЫLITERATURE REVIEWSРеабилитация пациентов после селективной дорсальной ризотомии при церебральном параличе: мировой опытRehabilitation after selective dorsal rhizotomy in cerebral palsy: world experience in literature reviewКурмановаД. Б.KurmanovaD. B.

Динара Батыржановна Курманова 

050012, г. Алматы, ул. Толе би, 94

Dinara Batyrzhanovna Kurmanova

050012, Almaty c., Tole bi str., 94

d.kurmanova368@gmail.comТуруспековаС. Т.TuruspekovaS. T.

050012, г. Алматы, ул. Толе би, 94

050012, Almaty c., Tole bi str., 94

info@kaznmu.kzЛисникВ. С.LisnicV. S.

MD-2004, г. Кишинев, Б. Стефана Великого, 165

MD-2004, Chisinau c., B. Stephen the Great, 165

contact@usmf.mdМухамбетоваГ. А.MukhambetovaG. A.

050012, г. Алматы, ул. Толе би, 94

050012, Almaty c., Tole bi str., 94

info@kaznmu.kzРабандияровМ. Р.RabandiyarovM. R.

050062, г. Алматы, м-он 2, д. 54

050062, Almaty c., distr. 2, 54

dgkb2_dgkb2@med.mail.kzЖайлгановА. А.ZhailganovА. A.

050062, г. Алматы, м-он 2, д. 54

050062, Almaty c., distr. 2, 54

dgkb2_dgkb2@med.mail.kzКасеноваГ. Н.KasenovaG. N.

050062, г. Алматы, м-он 2, д. 54

050062, Almaty c., distr. 2, 54

dgkb2_dgkb2@med.mail.kzНАО «Казахский национальный медицинский университет им. С. Д. Асфендиярова»КазахстанNC JSC «Kazakh National Medical University named after S. D. Asfendiyarov»KazakhstanГосударственный университет медицины и фармации им. Николая ТестемицануМолдоваState University of Medicine and Pharmacy named after Nicolae TestemitanuMoldova, Republic ofДетская городская клиническая больница №2 г. АлматыКазахстанChildren’s City Clinical Hospital No. 2Kazakhstan202612102026033041Copyright © Курманова Д.Б., Туруспекова С.Т., Лисник В.С., Мухамбетова Г.А., Рабандияров М.Р., Жайлганов А.А., Касенова Г.Н., 20262026Курманова Д.Б., Туруспекова С.Т., Лисник В.С., Мухамбетова Г.А., Рабандияров М.Р., Жайлганов А.А., Касенова Г.Н.Kurmanova D.B., Turuspekova S.T., Lisnic V.S., Mukhambetova G.A., Rabandiyarov M.R., Zhailganov А.A., Kasenova G.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://medecol.qmu.kz/jour/article/view/1367

Одним из методов коррекции спастичности мышц при церебральном параличе (ЦП) является оперативный метод – селективная дорсальная ризотомия (СДР). Эффективность данного метода зависит от индивидуальной программы пациента (ИПР), своевременности, качества и длительности реабилитационных мероприятий. В обзоре представлена историческая справка развития СДР, показан мировой опыт проведения реабилитации пациентам с ЦП после СДР, а также выделены важные факторы, которые влияют на эффективность реабилитации пациентов. Эффективность СДР напрямую зависит от правильно подобранной индивидуальной программы реабилитации, включающей в себя раннее начало физической терапии, оптимальную интенсивность нагрузок и междисциплинарный подход. Также отражены основные этапы становления и развития метода, анализируются современные подходы к восстановительному лечению, приведены примеры международных протоколов, определяющих частоту, длительность и последовательность реабилитационных мероприятий. Особое внимание уделено значению послеоперационной кинезиотерапии, физиотерапии, нейроразвивающих методик и психологической поддержки семьи. Показана необходимость стандартизации реабилитационных программ и повышения приверженности пациентов к длительному лечению. Проведенный анализ подтверждает, что сочетание хирургической коррекции и комплексной реабилитации обеспечивает наилучшие функциональные исходы, способствует восстановлению самостоятельности, устойчивому повышению качества жизни и формированию доказательной базы для совершенствования национальных протоколов реабилитации.

One of the surgical methods used to correct muscle spasticity in cerebral palsy (CP) is selective dorsal rhizotomy (SDR). The effectiveness of this method depends on the patient’s individual rehabilitation program (IRP), as well as on the timeliness, quality, and duration of rehabilitation interventions. This review presents a historical overview of SDR development, summarizes global experience in post-SDR rehabilitation for patients with CP, and highlights the key factors influencing its effectiveness. The success of SDR largely relies on a well-designed rehabilitation program that includes early initiation of physical therapy, optimal training intensity, and a multidisciplinary approach. The paper outlines the main stages of SDR evolution, analyzes current rehabilitation strategies, and provides examples of international protocols defining the frequency, duration, and sequence of therapeutic interventions. Special attention is given to postoperative kinesiotherapy, physiotherapy, neurodevelopmental techniques, and psychological support for families. The review emphasizes the need for standardization of rehabilitation programs and increased patient adherence to long-term therapy. The analysis confirms that combining surgical correction with comprehensive rehabilitation ensures optimal functional outcomes, promotes independence, improves quality of life, and strengthens the evidence base for developing national rehabilitation protocols.

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Rev. 2019; 7 (11): e3. https://doi.org/10.2106/JBJS.RVW.19.00020Chugh D., Cawker S.P., Katchburian L., Carr L.J., Aquilina K., Morgan S., Harding C. Quality of Movement Changes in Ambulatory Children with Cerebral Palsy 1 Year after Selective Dorsal Rhizotomy. Physiother. Can. 2025; 77 (1): 113-121. https://doi.org/10.3138/ptc-2023-002013Chugh D., Cawker S.P., Katchburian L., Carr L.J., Aquilina K., Morgan S., Harding C. Quality of Movement Changes in Ambulatory Children with Cerebral Palsy 1 Year after Selective Dorsal Rhizotomy. Physiother. Can. 2025; 77 (1): 113-121. https://doi.org/10.3138/ptc-2023-002013Chugh D., Waite G., Harniess P. et al. «I didn’t know was going to happen»: children’s and young people’s experiences and their involvement before and after selective dorsal rhizotomy. 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Child’s nervous system. 2024; 40 (2): 487-494. https://doi.org/10.1007/s00381-023-06124-7Lynch M.E., Daniels D.J., Brandenburg J. Gabapentin as part of a multimodal pain control for selective dorsal rhizotomy does not impact percentage of rootlets transected. Child’s nervous system. 2024; 40 (2): 487-494. https://doi.org/10.1007/s00381-023-06124-7Meyer-Sauvage J., Krouma M., Klovan C. et al. The effect of selective dorsal rhizotomy on the improvement of the quality of life of children with stage GMFCS IV and V cerebral palsy: pain, nursing,positioning, and dressing. Child’s nervous system. 2024; 40 (4): 987-995. https://doi.org/10.1007/s00381-024-06321-yMeyer-Sauvage J., Krouma M., Klovan C. et al. The effect of selective dorsal rhizotomy on the improvement of the quality of life of children with stage GMFCS IV and V cerebral palsy: pain, nursing,positioning, and dressing. Child’s nervous system. 2024; 40 (4): 987-995. https://doi.org/10.1007/s00381-024-06321-yMishraa D., Barikb S., Rajb V., Kandwalc. P. A systematic review of complications following selective dorsal rhizotomy in cerebral palsy. Neurochirurgie. 2023; 69: 8. https://doi.org/10.1016/j.neuchi.2023.101425Mishraa D., Barikb S., Rajb V., Kandwalc. P. A systematic review of complications following selective dorsal rhizotomy in cerebral palsy. 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The authors declare that there are no conflicts of interest present.