Functional performance following selective posterior rhizotomy: long-term results determined using a validated...

Area of Science:

• Neurosurgery
• Pediatric Orthopedics
• Rehabilitation Medicine

Background:

• Selective posterior rhizotomy (SPR) is a surgical option for managing spasticity in children with cerebral palsy.
• Long-term functional outcomes following SPR are not well-documented using validated measures.
• This study addresses the need for long-term data on SPR efficacy.

Purpose of the Study:

• To evaluate the long-term functional performance outcomes in children with spastic cerebral palsy after selective posterior rhizotomy (SPR).
• To assess the durability of functional improvements beyond 3 years post-surgery.
• To analyze data from the McGill Rhizotomy Database for long-term SPR results.

Main Methods:

• Retrospective analysis of patients undergoing lumbosacral dorsal rhizotomy with intraoperative electrophysiological monitoring.
• Preoperative and postoperative evaluations by a multidisciplinary team at 6 months, 1, 3, and 5 years.
• Quantitative assessment of activities of daily living (ADL) using the Pediatric Evaluation of Disability Inventory (PEDI).

Main Results:

• Significant improvements in mobility and self-care domains of the PEDI functional skills dimension were observed at 1 year post-SPR.
• Mobility domain scores increased from 56 preoperatively to 77.8 at 5 years postoperatively.
• Self-care domain scores improved from 59 preoperatively to 82.4 at 5 years postoperatively.

Conclusions:

• SPR demonstrates significant and sustained improvements in functional performance, specifically in mobility and self-care, for children with spastic cerebral palsy.
• These functional benefits persist up to 5 years after surgery.
• SPR utilizing intraoperative stimulation is a valuable intervention for enhancing motor function and ADL performance in this population.