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Orthopedic procedures after rhizotomy

K L Carroll1, K R Moore, P M Stevens

  • 1Primary Children's Medical Center, Salt Lake City, Utah, USA.

Journal of Pediatric Orthopedics
|February 4, 1998
PubMed
Summary
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Selective Dorsal Rhizotomy (SDR) effectively reduces spasticity in cerebral palsy patients. However, long-term orthopedic interventions are often necessary for contractures and joint stabilization.

Area of Science:

  • Neurosurgery
  • Pediatric Orthopedics
  • Neurology

Background:

  • Selective Dorsal Rhizotomy (SDR) is a surgical procedure aimed at reducing lower extremity spasticity.
  • Cerebral palsy (CP) is a common neurological disorder affecting movement and posture.

Purpose of the Study:

  • To evaluate the long-term outcomes of Selective Dorsal Rhizotomy (SDR) in patients with cerebral palsy.
  • To assess changes in tone, need for orthopedic intervention, and ambulatory status post-SDR.

Main Methods:

  • Retrospective review of 131 patients who underwent SDR between 1986 and 1994.
  • Analysis of tone (Ashworth scale), ambulatory status, and orthopedic interventions in 112 patients with adequate follow-up.

Main Results:

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  • All 112 patients showed decreased tone post-SDR.
  • No significant change in ambulatory status was observed.
  • 65% of patients required orthopedic intervention for contractures and deformities; 25% needed hip subluxation treatment.

Conclusions:

  • While SDR effectively reduces spasticity, long-term orthopedic management is crucial for managing residual issues like contractures and joint instability.
  • Parents should be informed about the likelihood of requiring further surgical interventions post-SDR.