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Functional outcome after selective dorsal rhizotomy: a retrospective case control study.

C P Chow1, L Y Wong2, C Y C Poon2

  • 1Child Assessment Service, Department of Health, Hong Kong SAR, China. chin_pang_chow@dh.gov.hk.

Child'S Nervous System : Chns : Official Journal of the International Society for Pediatric Neurosurgery
|November 18, 2023
PubMed
Summary

Selective dorsal rhizotomy (SDR) reduces spasticity long-term in children with spastic diplegia. However, this study found no significant long-term improvements in functional outcomes or quality of life compared to controls.

Keywords:
AdolescentsCerebral palsyQuality of life

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Area of Science:

  • Pediatric Neurology
  • Neurosurgery
  • Rehabilitation Medicine

Background:

  • Spastic diplegia is a common form of cerebral palsy affecting lower limbs.
  • Selective dorsal rhizotomy (SDR) is a surgical procedure to reduce spasticity.
  • Long-term outcomes of SDR on functional status and quality of life require further investigation.

Purpose of the Study:

  • To evaluate the long-term functional outcomes and quality of life in children with spastic diplegia following SDR.
  • To compare functional outcomes between children who underwent SDR and a matched control group.

Main Methods:

  • A case control study design was employed.
  • Participants were children with spastic diplegia 6-12 years post-SDR, compared to matched controls without SDR.
  • Outcome measures included physical, functional, and physiological levels, and quality of life, analyzed using independent t-tests.

Main Results:

  • The SDR group showed a statistically significant improvement in ankle dorsiflexion range in knee extension (-5.7° ± 10.9°).
  • No other significant differences were observed between the SDR and control groups in functional outcomes or quality of life.
  • The study included 15 participants in the SDR group and 12 in the control group.

Conclusions:

  • Selective dorsal rhizotomy (SDR) is a safe procedure that effectively reduces spasticity long-term with no major complications.
  • Despite spasticity reduction, this study did not demonstrate significant long-term differences in functional outcomes or quality of life between groups.
  • Heterogeneity among participants may have influenced the observed results, highlighting the need for further research.