Single Event Multilevel Surgery in children with bilateral spastic cerebral palsy: a 5 year prospective cohort study

Area of Science:

• Orthopedic Surgery
• Pediatric Neurology
• Rehabilitation Medicine

Background:

• Single Event Multilevel Surgery (SEMLS) is a standard treatment for improving gait and function in children with bilateral spastic cerebral palsy (BSCP).
• Previous randomized controlled trials (RCTs) showed improvements at 12 and 24 months post-surgery.
• This study aimed to assess the long-term maintenance of these improvements at 5 years.

Purpose of the Study:

• To determine if the gait and functional improvements achieved after SEMLS in children with BSCP are sustained at a 5-year follow-up.
• To evaluate the long-term efficacy of SEMLS in managing gait and motor function deficits in pediatric cerebral palsy.

Main Methods:

• A prospective cohort study followed 19 children with BSCP (GMFCS levels II-III) for 5 years post-SEMLS.
• Outcome measures included Gait Profile Score (GPS), Gillette Gait Index (GGI), Gait Deviation Index (GDI), Gross Motor Function Measure (GMFM66), and Functional Mobility Scale (FMS).

Main Results:

• Eighteen children completed the 5-year follow-up; one was excluded due to neurological deterioration (revised diagnosis to HSP).
• Significant improvements were observed at 5 years: GPS improved by 5.29° and GMFM66 by 3.3%.
• No significant differences were found between 1-year and 5-year, or 2-year and 5-year outcomes (except GMFM66), indicating stable improvements.

Conclusions:

• SEMLS leads to clinically and statistically significant improvements in gait and function for children with BSCP.
• These improvements are maintained at the 5-year follow-up point, confirming the long-term benefits of the surgical intervention.