Foot contact pattern following selective dorsal rhizotomy

Fourteen ambulatory patients with spastic cerebral palsy were evaluated prior to and 6 months following selective dorsal rhizotomy. An instrumented gait analysis identified significant improvements in foot contact patterns, velocity and stride length. The high incidence of postoperative valgus, excessive dorsiflexion and persistent knee flexion during gait was attributed to significant weakness and hypotonicity in the plantar flexors, as well as residual hamstring spasticity (p < 0.05). Sectioning of fewer S-1 rootlets may preserve plantar flexion strength and enhance stance stability by preventing postoperative increases in dorsiflexion and knee flexion. Orthotic prescription for ankle instability should be a routine postoperative consideration.