Spinal Deformity After Selective Dorsal Rhizotomy in Ambulatory Patients With Cerebral Palsy

Johnson, Michael B.; Goldstein, Liav; Thomas, Susan; Piatt, Joseph H.; Aiona, Michael D.; Sussman, Michael D.

doi:10.1097/01241398-200409000-00013

Cited by 69 publications

(37 citation statements)

References 27 publications

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“…found scoliosis in 17% of their group, with average curve magnitude of 16°. Johnson et al 8 . found scoliosis in 24%, and Golan et al., 9 in a study that used upright radiographs, found scoliosis in 45% but only 5% had a curve greater than 25°.…”

Section: How Often Do Scoliosis (Or Other Spine Deformities) Developmentioning

confidence: 96%

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Scoliosis in cerebral palsy

Koop

2009

Develop Med Child Neuro

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Spinal deformity is a common musculoskeletal problem for individuals with cerebral palsy. Severe scoliosis may impair physical function and may be a source of pain. Spine braces and carefully constructed seating arrangements may moderate the behavior of these deformities but do not seem capable of stopping progression, which often continues in adulthood. Spine fusion surgery can produce a stable, durable trunk shape that improves sitting and positioning but the process of surgery is arduous and outcomes can be compromised by numerous serious complications. Despite complications, many families and caregivers express satisfaction with the results of surgery. Careful patient evaluation, studious attention to surgical planning and performance, and a good relationship with patients, family members, and other providers is essential.

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Section: How Often Do Scoliosis (Or Other Spine Deformities) Developmentioning

confidence: 96%

“…They reported lumbosacral spondylolisthesis in 12% of their group, all but one grade I in severity. Johnson et al 8 . found spondylolisthesis in 18%, and Golan et al 9 .…”

Section: How Often Do Scoliosis (Or Other Spine Deformities) Developmentioning

confidence: 96%

Scoliosis in cerebral palsy

Koop

2009

Develop Med Child Neuro

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“…However, there is conflicting evidence with respect to possible associations between the presence of pelvic obliquity and hip dislocation and the onset and progression of scoliosis [51]. In addition, some children undergoing selective dorsal rhizotomy appear to be at some risk for the development of scoliosis and other spinal deformities [30,50,41,101,103,109]. Similarly, there are conflicting reports regarding the use of intrathecal Baclofen and its effects on the progression of scoliosis [29,93,94,97].…”

Section: Spinementioning

confidence: 99%

Orthotic management of cerebral palsy: Recommendations from a consensus conference

Morris

Bowers

Ross

et al. 2011

NRE

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An international multidisciplinary group of healthcare professionals and researchers participated in a consensus conference on the management of cerebral palsy, convened by the International Society for Prosthetics and Orthotics. Participants reviewed the evidence and considered contemporary thinking on a range of treatment options including physical and occupational therapy, and medical, surgical and orthotic interventions. The quality of many of the reviewed papers was compromised by inadequate reporting and lack of transparency, in particular regarding the types of patients and the design of the interventions being evaluated. Substantial evidence suggests that ankle-foot orthoses (AFOs) that control the foot and ankle in stance and swing phases can improve gait efficiency in ambulant children (GMFCS levels I-III). By contrast, little high quality evidence exists to support the use of orthoses for the hip, spine or upper limb. Where the evidence for orthosis use was not compelling consensus was reached on recommendations for orthotic intervention. Subsequent group discussions identified recommendations for future research. The evidence to support using orthoses is generally limited by the brevity of follow-up periods in research studies; hence the extent to which orthoses may prevent deformities developing over time remains unclear. The full report of the conference can be accessed free of charge at www.ispoint.org.

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“…Judicious intraoperative EMG monitoring is a widely performed and evidence-based approach and used to mitigate against severe lower limb weakness and incontinence (36). The literature suggests that in the long term, patients may experience increased lordosis and hip subluxation (6,32,37,38), but there is insufficient evidence to attribute the complications to SDR or the natural history of CP (30). However, the single-level laminectomy aims to significantly reduce the likelihood and severity of these complications (11).…”

Section: Outcome Of Sdrmentioning

confidence: 99%

Single-level selective dorsal rhizotomy for spastic cerebral palsy

Graham¹,

Aquilina²,

Cawker³

et al. 2016

J. Spine Surg.

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The management of cerebral palsy (CP) is complex and requires a multidisciplinary approach. Selective dorsal rhizotomy (SDR) is a neurosurgical technique that aims to reduce spasticity in the lower limbs.A minimally invasive approach to SDR involves a single level laminectomy at the conus and utilises intraoperative electromyography (EMG). When combined with physiotherapy, SDR is effective in selected children and has minimal complications. This review discusses the epidemiology of CP and the management using SDR within an integrated multidisciplinary centre. Particular attention is given to the single-level laminectomy technique of SDR and its rationale, and the patient workup, recovery and outcomes of SDR.

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Spinal Deformity After Selective Dorsal Rhizotomy in Ambulatory Patients With Cerebral Palsy

Cited by 69 publications

References 27 publications

Scoliosis in cerebral palsy

Scoliosis in cerebral palsy

Orthotic management of cerebral palsy: Recommendations from a consensus conference

Single-level selective dorsal rhizotomy for spastic cerebral palsy

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