Changes in Hip Geometry after Selective Dorsal Rhizotomy in Children with Cerebral Palsy

Abstract

The results confirm that SDR improves hip geometry as well as function in ambulatory CP children. Long-term studies need to show whether this radiographic improvement has clinical relevance with regard to pain and function.

Prevention of hip displacement in children with cerebral palsy: a systematic review

“…Four studies concluded SDR may have a positive effect on hip displacement . Annual change in migration percentage could only be calculated for Floeter et al at −1.7% per year.…”

“…Four non‐English language publications that addressed the study question were excluded. After full‐text review, 23 papers remained . A search of the reference lists of these articles and key articles on hip displacement identified one additional article (Greene et al).…”

“…In total, 24 articles were included in our systematic review, encompassing studies that investigated the use of BoNT-A, [35][36][37][38] BoNT-A and bracing, 39,40 CAM therapies, 41 ITB, 42 obturator nerve block, 43 positioning, [44][45][46][47][48][49][50]59 and SDR. [51][52][53][54][55][56]58 Table SII (online supporting information) summarizes the study design, level of evidence and quality score, participant characteristics, intervention, and length of followup of the included studies. Conduct scores are provided in Table SIII (online supporting information).…”

“…The impact of SDR on hip displacement was reported in seven studies, all graded as level 4 or 5 evidence. [51][52][53][54][55][56]58 The percentage of afferent rootlets cut varied considerably within and between studies (5%-85%).…”

“…Four studies concluded SDR may have a positive effect on hip displacement. [52][53][54]56 Annual change in migration percentage could only be calculated for Floeter et al 52 at À1.7% per year. Three of these studies reported stability rates, whereby the migration percentage was either unchanged or improved, in 82% to 93% of hips; mean length of follow-up was 4 years or less.…”