Long-term functional outcome after selective posterior rhizotomy.

Area of Science:

• Neurosurgery
• Pediatric Orthopedics
• Rehabilitation Medicine

Background:

• Selective posterior rhizotomy (SPR) is a surgical intervention for spastic cerebral palsy (CP).
• Long-term quantitative outcome data beyond three years post-SPR are limited.
• Intraoperative electrophysiological monitoring is utilized during SPR.

Purpose of the Study:

• To evaluate the long-term functional outcomes of SPR in children with spastic CP.
• To assess the durability of surgical benefits up to five years post-procedure.

Main Methods:

• Analysis of data from the McGill Rhizotomy Database.
• Inclusion of children with spastic CP undergoing SPR with intraoperative monitoring.
• Quantitative assessments of spasticity, range of motion, strength, and ambulatory function at baseline and 1, 3, and 5 years post-surgery.

Main Results:

• Significant improvements in spasticity, range of motion, and muscle strength were observed at one year, persisting through five years.
• The Gross Motor Function Measure global score improved from 64.6 preoperatively to 85.6 at five years.
• Greatest improvements were noted in lower-extremity motor function, with a 34.4% increase at five years.

Conclusions:

• SPR, with intraoperative stimulation, leads to lasting improvements in lower-limb function for children with spastic CP.
• The surgical procedure effectively alleviates spasticity and enhances motor capabilities long-term.
• The study supports SPR as a valuable treatment for improving functional outcomes in spastic CP.