Patients and Parents' Satisfaction and Self-Reported Evaluation After Single-Event Multilevel Surgery in Cerebral...

Area of Science:

• Orthopedics
• Neurology
• Pediatrics

Background:

• Cerebral palsy (CP) is a common neurodevelopmental disorder affecting movement.
• Spastic diplegic CP significantly impacts gait and community ambulation.
• Single-event multilevel surgery (SEMLS) is a surgical approach to address complex gait deviations in CP.

Purpose of the Study:

• To evaluate the effectiveness of SEMLS in cerebral palsy (CP) using objective gait analysis and patient-reported outcomes.
• To identify predictors of successful surgical outcomes in CP patients undergoing SEMLS.

Main Methods:

• A retrospective analysis of 258 spastic diplegic CP patients (GMFCS I-III) who underwent SEMLS (SEMLS group) and 88 controls.
• Preoperative and postoperative gait analyses including the Gait Deviation Index (GDI).
• Comparison of demographic data, GDI, and self-reported satisfaction between groups.

Main Results:

• The SEMLS group showed a significant GDI improvement (51.3 to 58.4, P <0.001), unlike the control group.
• Improved community walking distances were observed in SEMLS patients with GDI increase >5 points (24.7%) and in GMFCS I-II (20.4%).
• High patient (51.1%) and parental (60.1%) satisfaction was reported, with significant improvements in self-esteem, mobility, and independence.

Conclusions:

• SEMLS can improve community walking in CP patients, particularly those with GDI improvement >5 points and GMFCS I-II.
• Patient and parental satisfaction with SEMLS is generally high, indicating positive functional and psychosocial benefits.
• Objective gait improvements correlate with enhanced self-reported quality of life after SEMLS in CP.