Long-term outcomes five years after selective dorsal rhizotomy.

Area of Science:

• Neurosurgery
• Pediatric Orthopedics
• Rehabilitation Medicine

Background:

• Selective dorsal rhizotomy (SDR) is a neurosurgical intervention for spasticity in cerebral palsy (CP).
• Long-term outcome data for SDR in pediatric spastic diplegia are limited.
• This study evaluates the 5-year functional outcomes of SDR combined with physiotherapy.

Purpose of the Study:

• To assess the long-term functional outcomes of SDR in children with spastic diplegia.
• To evaluate the safety and side effects of SDR over a five-year postoperative period.
• To determine the efficacy of SDR in conjunction with physiotherapy.

Main Methods:

• 35 children with spastic diplegia (26 GMFCS III-V) underwent SDR.
• Assessments included GMFCS, GMFM, PEDI, muscle tone (Ashworth scale), and PROM.
• Data were collected preoperatively and at 6, 12, 18 months, and 3 and 5 years postoperatively.

Main Results:

• Mean 40% of rootlets (S2-L2) were resected; spasticity was immediately reduced and remained so.
• Significant improvements were observed in PROM, GMFM, and PEDI scores over 5 years.
• No major adverse side effects were reported.

Conclusions:

• SDR is a safe and effective treatment for permanent spasticity reduction in pediatric spastic diplegia.
• Combined with physiotherapy, SDR provides sustained functional benefits for up to five years.
• Careful patient selection and systematic follow-up are crucial for optimal outcomes.