Surgical results of selective dorsal rhizotomy for the treatment of spastic cerebral palsy

Abstract

A BSTRACT Background: Selective dorsal rhizotomy (SDR) is one of the surgical alternatives for treating spasticity, especially in children with spastic diplegia secondary to cerebral palsy (CP). It is becoming increasingly used, and the results of this operation need to be further highlighted. Aim: The main objective of this article was to present the results of such surgical procedure in a cohort of a specialized center, with a particular focus on a quantitative analysis (goniometry). Materials and Methods: Retrospective review of the medical records and gait analyses of a cohort of 34 patients diagnosed with CP submitted to elective SDR at our institution, in a period of 6 years, was carried out. All patients underwent a thorough clinical and neurological assessment, gait analysis at a dedicated laboratory, and magnetic resonance imaging of whole neuro-axis. Statistical Analysis: For continuous quantitative variables (goniometric angles and muscle tone), a t -student test was used. A scatterplot regression analysis was used for the comparison of modified Ashworth scale (mAS) scores and goniometry measurements. Results and Conclusion: In a mean follow-up of 3.2 years, SDR provides a measurable and consistent improvement in the motor function of spastic patients, as per range of motion and tonus scales, with low complication rates. It also allows for patients to reduce their use of muscle relaxants, even though their global mobility does not change significantly. Therefore, it should be considered for CP patients who suffer with the deleterious effects of spasticity.

Selektyvios Dorzalinės Rizotomijos Poveikis Cerebriniu Paralyžiumi Sergančių Vaikų Kojų Raumenų Tonusui, Elektriniam Aktyvumui, Eisenai

“…SDR operacija leidžia sumažinti raumenų relaksantų vartojimą, net jei jų mobilumas iš esmės nesikeitė. Tyrėjų manymu, ši procedūra turėtų būti taikoma sergančiųjų cerebriniu paralyžiumi spastiškumui mažinti [9]. Ši intervencija buvo naudojama pastaruosius 40 metų, siekiant valdyti spastiškumą, atsirandantį dėl cerebrinio paralyžiaus [10].…”

“…S. Volpon su bendraautoriais čiurnos sąnario amplitudę vertino standartine goniometrija. Mūsų tyrime pėdos judesių amplitudė buvo vertinama eisenos metu [9].…”