PMID- 21585367
OWN - NLM
STAT- MEDLINE
DCOM- 20110902
LR  - 20220321
IS  - 1469-8749 (Electronic)
IS  - 0012-1622 (Linking)
VI  - 53
IP  - 8
DP  - 2011 Aug
TI  - Does loss of spasticity matter? A 10-year follow-up after selective dorsal 
      rhizotomy in cerebral palsy.
PG  - 724-9
LID - 10.1111/j.1469-8749.2011.03969.x [doi]
AB  - AIM: The aim of this study was to evaluate the long-term effects of selective 
      dorsal rhizotomy (SDR) in children with cerebral palsy (CP). METHOD: Nineteen 
      children (four females, 15 males; mean age 4y 7mo, SD 1y 7mo) with bilateral 
      spastic CP, were prospectively assessed at baseline and 18 months, 3 years, and 
      10 years after SDR. Assessments included the Modified Ashworth Scale for 
      spasticity, the Gross Motor Function Measure 88 (GMFM-88) and the Wilson gait 
      scale for ambulation, neurological investigations, and passive joint range of 
      motion assessment. A 10-year retrospective chart review was added for orthopaedic 
      surgery after SDR. RESULTS: Baseline muscle tone at the hip, knee, and ankle 
      level displayed a high degree of spasticity that normalized after SDR. After 10 
      years there was a slight recurrence of spasticity at the knee and ankle. Joint 
      range of motion declined from a maximum at 3 years after SDR to the 10-year 
      follow-up. Median ambulatory status was best 3 years after SDR and then declined. 
      The GMFM-88 score increased from the median baseline value of 51 to 66 (p=0.002) 
      and 76 (p<0.001) at the initial follow-ups. After 10 years there was a decline in 
      gross motor function with a reduction in the GMFM-88 score to 62 (p=0.022). 
      Within 10 years, 16 out of 19 patients had a mean of three orthopaedic surgeries 
      (SD 2.8), soft tissue surgery being the most common. INTERPRETATION: The 
      spasticity-reducing effect of SDR, although pronounced, did not seem to improve 
      long-term functioning or prevent contractures. This suggests that contracture 
      development in CP is not mediated by spasticity alone.
CI  - (c) 2011 The Authors. Developmental Medicine & Child Neurology (c) 2011 Mac Keith 
      Press.
FAU - Tedroff, Kristina
AU  - Tedroff K
AD  - Neuropediatric Unit, Department of Women's and Children's Health, Karolinska 
      Institutet, Astrid Lindgren Children's Hospital, Stockholm, Sweden. 
      kristina.tedroff@ki.se
FAU - Lowing, Kristina
AU  - Lowing K
FAU - Jacobson, Dan N O
AU  - Jacobson DN
FAU - Astrom, Eva
AU  - Astrom E
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20110518
PL  - England
TA  - Dev Med Child Neurol
JT  - Developmental medicine and child neurology
JID - 0006761
SB  - IM
CIN - Dev Med Child Neurol. 2011 Aug;53(8):678. PMID: 21585368
MH  - Cerebral Palsy/*surgery
MH  - Child
MH  - Child, Preschool
MH  - Disability Evaluation
MH  - Female
MH  - Gait
MH  - Humans
MH  - Longitudinal Studies
MH  - Male
MH  - Muscle Spasticity/*etiology
MH  - Orthopedic Procedures/methods
MH  - Postoperative Complications/*etiology
MH  - Range of Motion, Articular
MH  - Retrospective Studies
MH  - Rhizotomy/*adverse effects
MH  - Severity of Illness Index
MH  - Statistics as Topic
MH  - Statistics, Nonparametric
MH  - Time Factors
MH  - Treatment Outcome
EDAT- 2011/05/19 06:00
MHDA- 2011/09/03 06:00
CRDT- 2011/05/19 06:00
PHST- 2011/05/19 06:00 [entrez]
PHST- 2011/05/19 06:00 [pubmed]
PHST- 2011/09/03 06:00 [medline]
AID - 10.1111/j.1469-8749.2011.03969.x [doi]
PST - ppublish
SO  - Dev Med Child Neurol. 2011 Aug;53(8):724-9. doi: 
      10.1111/j.1469-8749.2011.03969.x. Epub 2011 May 18.