Related Experiment Video
Updated: Jul 21, 2025
3D Printing Model of a Patient's Specific Lumbar Vertebra
Published on: April 14, 2023
The Effect of Selective Dorsal Rhizotomy on Hip Displacement in Children With Cerebral Palsy: A Long-term Follow-up
Stacey D Miller1, Maria Juricic1, Jeffrey N Bone2
1Department of Physical Therapy, BC Children's Hospital, University of British Columbia, Vancouver, BC, Canada.
Insights
Selective dorsal rhizotomy (SDR) does not impact hip displacement in children with cerebral palsy (CP) long-term. This study found SDR has neither a positive nor negative effect on hip displacement at least 5 years post-intervention.
Area of Science:
- Pediatric Orthopedics
- Pediatric Neurology
- Rehabilitation Medicine
Background:
- Hip displacement is a common complication in children with cerebral palsy (CP).
- Spasticity in hip adductor muscles, hip flexors, and medial hamstrings is a suspected cause of progressive hip displacement.
- Selective dorsal rhizotomy (SDR) is a surgical procedure to reduce lower extremity spasticity in children with CP.
Purpose of the Study:
- To investigate the long-term influence of Selective Dorsal Rhizotomy (SDR) on hip displacement in children with cerebral palsy (CP).
- To assess the effect of SDR on hip displacement at a minimum of 5 years post-intervention.
Main Methods:
- Retrospective review of children with CP who underwent SDR at a Canadian pediatric hospital.
- Measurement of migration percentage (MP) on pelvis radiographs before SDR and at minimum 5 years post-SDR.
- Analysis of risk factors for poor outcome (MP >40% or hip surgery) using a linear mixed-effects model.
Main Results:
- Ninety children (GMFCS levels I-V) with a mean follow-up of 8.5 years were included.
- Over half (52%) had hip displacement pre-SDR.
- Post-SDR, hip displacement incidence varied by GMFCS level, with higher levels showing greater displacement. Poor outcome was linked to preoperative MP, age, and GMFCS level.
Conclusions:
- The incidence of hip displacement post-SDR aligns with population-based studies when stratified by GMFCS level.
- Selective Dorsal Rhizotomy (SDR) demonstrates neither a positive nor negative effect on hip displacement at long-term follow-up (≥5 years).
Background:
Hip displacement is common in children with cerebral palsy (CP). Spasticity in the hip adductor muscles, hip flexors, and medial hamstrings has been identified as a possible cause of progressive hip displacement. Selective dorsal rhizotomy (SDR) aims to reduce lower extremity spasticity in children with CP. Here, we investigate the influence of SDR on hip displacement in children with CP at long-term follow-up, a minimum of 5 years post-SDR.
Methods:
A retrospective review of children undergoing SDR at a Canadian pediatric hospital was completed. Migration percentage (MP) was measured on pelvis radiographs taken in the 6 months before SDR and minimum 5 years post-SDR or before hip surgery. The number of hips with displacement, defined as MP >30%, and the number of children with at least 1 hip displaced were determined. A linear mixed-effects model was used to assess potential risk factors for poor outcome post-SDR, defined as having MP >40% or surgical intervention for hip displacement.
Results:
Ninety children [50 males, 40 females, Gross Motor Function Classification System (GMFCS) levels I to V: 1/13/24/43/9] with a mean follow-up of 8.5 years (SD 5.1) were included. The mean age at SDR was 4.9 years (SD 1.5); more than half of children (52%) had hip displacement at the time of SDR. Post-SDR, MP exceeded 30% in 0 (0%) of children at GMFCS level I, 1 (8%) at II, 11 (46%) at III, 31 (72%) at IV, and 7 (78%) at V. A poor outcome was associated with preoperative MP, age, and GMFCS level.
Conclusions:
The incidence of hip displacement post-SDR was consistent with population-based studies when evaluated by GMFCS. Our findings suggest that SDR has neither a positive nor negative effect on hip displacement when assessed at least 5 years postintervention.
Level Of Evidence:
Level IV.
More Related Videos
05:04Enhancing the Development and Growth of Infant Cerebral Palsy Rats Using Selective Spinal Manipulations
Published on: February 2, 2024
09:51The Transition to an Anterior-Based Muscle Sparing Approach Improves Early Postoperative Function but is Associated with a Learning Curve
Published on: September 7, 2022