• Toshiki Inotani, Akira Horaguchi, Yuko Morishita, Ayuko Yoshida, Misaki Otomo, Makoto Suzuki, Takehiko Inui, Yukimune Okubo, Shigemasa Komatsu, Chika Mizuno, Yuko Takahashi, Tatsuhiro Ochiai, Takeshi Kinjo, Takashi Asato, Jun Takayama, Gen Tamiya, Naoya Saijo, Atsuo Kikuchi, and Kazuhiro Haginoya.
• Department of Rehabilitation and Developmental Support, Miyagi Children's Hospital.
• Tohoku J. Exp. Med. 2024 Apr 24; 262 (4): 239244239-244.

AbstractSelective dorsal rhizotomy (SDR) has been used to treat children with spastic cerebral palsy (CP), and its beneficial effect on quality of life and ambulation has been confirmed in long-term follow-up studies. However, the role of SDR in the treatment of spasticity in patients with hereditary spastic paraplegia (HSP) and related disorders is not well-established. Here, we report the first patient with the ZC4H2 variant who underwent SDR to treat spastic paraplegia. Abnormal gait was discovered during a regular checkup at the age of 3 years and 9 months, and she was diagnosed with spastic paraplegia. She was heterozygous for the ZC4H2 variant and underwent SDR at the age of 5 years and 11 months, which alleviated the spasticity. The patient underwent inpatient postoperative rehabilitation for 4 months and continued outpatient physiotherapy after discharge. The Gross Motor Function Measure-88 score and maximum walking speed decreased transiently 1 month postoperatively, but gradually recovered, and continuously improved 6 months postoperatively. SDR and postoperative intensive rehabilitation were effective in improving motor and walking functions up to 6 months after surgery, although long-term follow-up is needed to draw conclusions.

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