Related Experiment Video
Updated: Aug 18, 2026
Evaluation of Patients' Posture and Gait Profile After Lumbar Fusion Surgery by Video Rasterstereography and Treadmill Gait Analysis
Published on: March 23, 2019
Gait improvement surgery in diplegic children: how long do the improvements last?
Vinay Saraph1, Ernst-Bernhard Zwick, Claudia Auner
1Pediatric Orthopedic Unit, Department of Pediatric Surgery, Medical University of Graz, Auenbruggerplatz 34, A-8036 Graz, Austria. vinay.saraph@meduni-graz.at
Insights
Single-event multilevel surgery improves gait in children with cerebral palsy. However, gait function can decline post-surgery, suggesting long-term follow-up is crucial for assessing treatment outcomes.
Area of Science:
- Orthopedics
- Pediatric Surgery
- Rehabilitation Medicine
Background:
- Single-event multilevel surgery (SEMS) is a common treatment for ambulatory children with cerebral palsy (CP).
- Long-term follow-up studies assessing the durability of gait improvements after SEMS are limited.
- Retrospective analysis of gait data is essential for understanding treatment efficacy over time.
Purpose of the Study:
- To evaluate the maintenance of gait function improvements after SEMS in children with CP.
- To determine the optimal time point for assessing the long-term outcomes of gait improvement surgery.
- To analyze changes in kinematic and time-distance gait parameters post-surgery.
Main Methods:
- Retrospective review of gait analysis data from 32 diplegic children who underwent SEMS.
- Inclusion of sagittal plane kinematic parameters (hip, knee, ankle) and time-distance parameters.
- Three postoperative gait assessments: post-AFO discontinuation, post-splint discontinuation, and long-term follow-up (≥1.5 years post-therapy cessation).
Main Results:
- Gait function demonstrated ongoing changes between 1, 2, and 3 years post-surgery.
- A general decrease in gait function was observed between the first and second postoperative evaluations.
- Improvements achieved through SEMS may not be consistently maintained in the long term without continued monitoring.
Conclusions:
- Gait function continues to evolve for up to 3 years after single-event multilevel surgery in children with cerebral palsy.
- A minimum follow-up of 3 years post-surgery is recommended for a more accurate prediction of treatment outcomes.
- Further research into long-term gait maintenance strategies following SEMS is warranted.
Abstract:
Gait improvement surgery in ambulatory children with cerebral palsy performed as single-event multilevel surgery is today a well-established modality of treatment, but follow-up studies are lacking. Preoperative and follow-up gait analysis data of 32 diplegic children who underwent single-event multilevel surgery for gait improvement between 1995 and 1998 were evaluated retrospectively. Relevant sagittal plane kinematic parameters of the hip, knee, and ankle joint and time-distance parameters were considered for outcome measures in this study. Postoperative gait analysis was performed three times in all the cases: after discontinuation of the dynamic AFOs (mean 1.0 +/- 0.3 years), after discontinuation of the night splints (mean 2.3 +/- 0.7 years), and at least 1.5 years after discontinuation of physiotherapy and splints (mean 4.4 +/- 1.1 years). The aim of the study was to ascertain whether the improvements in gait function were maintained over these examinations. The authors found that gait function continued to change over 1, 2, and 3 years of follow-up. A general decrease in gait function was measurable in this collective between the first postoperative and the second postoperative evaluations. The results indicate that evaluation of gait improvement surgery in cerebral palsy performed at a minimum of 3 years after surgery would give the most predictive outcome of treatment.
