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Spasticity and strength changes as a function of selective dorsal rhizotomy
J R Engsberg1, K S Olree, S A Ross
1Human Performance Laboratory, Barnes-Jewish and St. Louis Children's Hospitals, St. Louis, Missouri; and Department of Neurosurgery, Washington University School of Medicine, St. Louis, Missouri.
Neurosurgical Focus
|January 9, 2007
Summary
Selective dorsal rhizotomy reduced hamstring spasticity in children with cerebral palsy (CP). Post-surgery, hamstring strength increased significantly in the CP group compared to pre-surgery levels.
Area of Science:
- Orthopedics
- Neurology
- Pediatrics
Background:
- Cerebral palsy (CP) often involves hamstring spasticity and weakness.
- Selective dorsal rhizotomy (SDR) is a surgical intervention for managing spasticity in CP.
Purpose of the Study:
- To quantify changes in hamstring muscle spasticity and strength in children with CP after SDR.
- To compare post-SDR outcomes with pre-SDR measurements and a control group.
Main Methods:
- Nineteen children with CP and six able-bodied children were assessed using a dynamometer.
- Spasticity was measured by hamstring muscle resistive torque during passive knee extension at varying speeds.
- Strength was assessed by measuring the work done during maximal hamstring muscle contraction.
Main Results:
- Pre-surgery, children with CP exhibited significantly greater hamstring spasticity than the able-bodied group.
- Post-surgery, hamstring spasticity in the CP group was no longer significantly different from the able-bodied group.
- Hamstring strength in the CP group remained lower than the able-bodied group but showed a significant increase from pre-surgery levels.
Conclusions:
- Selective dorsal rhizotomy effectively reduces hamstring spasticity in children with CP.
- SDR leads to significant improvements in hamstring strength in children with CP, contrary to some previous findings.
