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Foot contact pattern following selective dorsal rhizotomy
1Physical Therapy Program, California State University, Northridge 91330, USA.
Pediatric Neurosurgery
|January 1, 1995
Summary
Selective dorsal rhizotomy improved gait in spastic cerebral palsy patients. However, weakness and spasticity caused issues like valgus and knee flexion, suggesting technique modifications and orthotics are needed.
Area of Science:
- Neurology
- Orthopedics
- Biomedical Engineering
Background:
- Spastic cerebral palsy (CP) is a common motor disorder.
- Selective dorsal rhizotomy (SDR) is a surgical option for CP.
- Gait abnormalities are a primary concern in ambulatory CP patients.
Purpose of the Study:
- To evaluate the effects of SDR on gait in ambulatory spastic CP patients.
- To identify gait deviations and contributing factors post-SDR.
- To suggest modifications for optimizing SDR outcomes.
Main Methods:
- Instrumented gait analysis was performed on 14 ambulatory spastic CP patients.
- Evaluations were conducted before and 6 months after SDR.
- Statistical analysis was used to assess changes and correlations (p < 0.05).
Main Results:
- Significant improvements were observed in foot contact, velocity, and stride length post-SDR.
- High incidence of postoperative valgus, excessive dorsiflexion, and persistent knee flexion.
- Plantar flexor weakness, hypotonicity, and residual hamstring spasticity were identified as contributing factors.
Conclusions:
- SDR can improve gait parameters in spastic CP.
- Surgical technique, specifically S-1 rootlet sectioning, may influence outcomes.
- Preventing excessive dorsiflexion and knee flexion is crucial for stability.
- Routine postoperative orthotic prescription for ankle instability is recommended.