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Does gait continue to improve 2 years after selective dorsal rhizotomy?
S S Thomas1, M D Aiona, C E Buckon
1Shriners Hospital for Children, Portland, OR 97201, USA.
Journal of Pediatric Orthopedics
|May 1, 1997
Summary
Selective dorsal rhizotomy improves spastic diplegia gait, but most children still need orthopedic surgery. Gait changes are minimal between 1-2 years post-surgery, suggesting earlier intervention.
Area of Science:
- Neurology
- Orthopedics
- Pediatric Rehabilitation
Background:
- Selective dorsal rhizotomy (SDR) improves gait in children with spastic diplegia.
- Long-term gait changes after SDR are not well understood.
- Optimal timing for orthopedic surgery post-SDR remains unclear due to limited long-term data.
Purpose of the Study:
- To evaluate long-term gait pattern changes in children with spastic diplegia after SDR.
- To determine the optimal timing for orthopedic intervention following SDR.
Main Methods:
- Three-dimensional gait analysis was used.
- 23 children with spastic diplegia were assessed preoperatively, and at 1 and 2 years post-SDR.
Main Results:
- Significant improvements in hip, knee, and ankle motion were observed 1 year after SDR.
- Gait pattern improvements between 1 and 2 years post-SDR were not statistically significant.
Conclusions:
- Orthopedic intervention can be considered 1 year after SDR to maximize functional gains.
- Minimal gait changes occur between 1 and 2 years post-SDR, supporting earlier surgical timing.