Article

The aim of this study was to evaluate the long-term effect of selective
dorsal rhizotomy (SDR) on the gross motor function of ambulant children with
spastic bilateral cerebral palsy (CP), compared with reference centiles. METHOD: The study used a prospective cohort design and participants comprised 29 children
classified using the Gross Motor Function Classification System (GMFCS) in level
I (n=7), II (n=4), or III (n=18; 18 males, 11 females; median age at time of
surgery 6 y 4 mo; range 2 y 10 mo-12 y 1 mo), who were examined 5 years and 10
years after SDR. We used individual centiles based on Gross Motor Function
Measure (GMFM-66) scores and age, corresponding to the GMFCS levels. Individual
improvement or deterioration was defined as a change of more than 20 centiles.
Side effects experienced and additional treatment received after SDR were also
recorded. RESULTS: Five years after SDR, 10 out of 28 children showed
improvement, and 10 years after SDR 6 out of 20 children had improved. Spinal
side effects were noted in two children and hip subluxation in three. Additional
treatments included subtalar arthrodesis (n=13), endorotational osteotomy of the
tibia (n=5), and botulinum toxin treatment (n=13). INTERPRETATION: None of the
children showed deterioration of gross motor function based on centile ranking.
Five and 10 years after SDR, gross motor function in some children had improved
more than would have been expected according to the reference centiles. This
suggests, taking the limitations of this study into account, that the applied
criteria for selection were adequate. However, the children still required
additional treatment after SDR.
CI - (c) 2013 Mac Keith Press.

Langue : ANGLAIS