| Short- and long-term effects of selective dorsal rhizotomy on gross motor function in ambulatory children with spastic diplegia. | |
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MedLine Citation:
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PMID: 21529199 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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Object The primary aim of this prospective cohort study was to evaluate the short-term (1 year) and long-term (mean 6 years) effects of selective dorsal rhizotomy (SDR) on gross motor function and spasticity in ambulatory children with spastic diplegia. Secondary aims were to investigate side effects, additional treatment during follow-up (botulinum toxin type A injections or orthopedic surgery), and parental satisfaction. Methods Thirty-three children who had undergone SDR at a mean age of 6 years and 7 months (± 2 years) were included. There were 7 children at Gross Motor Function Classification System (GMFCS) Level I, 7 at Level II, and 19 at Level III. Gross motor function was assessed with the Gross Motor Function Measure-66 (GMFM-66). Spasticity was measured according to a modified Tardieu scale. Side effects, additional treatment, and parental satisfaction were recorded using a parental questionnaire and medical records. Results At 1-year follow-up, mean GMFM-66 scores improved significantly by 4.3 ± 4.1 points. Children at GMFCS Levels I and II showed significantly more improvement (7.2 points) on the GMFM-66 compared with children at GMFCS Level III (2.9 points). On long-term follow-up (mean 6 years ± 22 months), mean GMFM-66 scores improved significantly by 6.5 ± 5.9 points, without a difference between children at GMFCS Levels I and II and Level III. No relapse of spasticity was noted. Ten children (30%) needed orthopedic surgery and 13 children (39%) received botulinum toxin type A treatment after SDR. Twenty (91%) of the 22 parents who answered the questionnaire at long-term follow-up believed that their child's functioning had improved after SDR. Conclusions Selective dorsal rhizotomy resulted in short- and long-term improvements in gross motor function, without relapse of spasticity. However, the majority of the children still needed additional surgery or botulinum toxin A treatment. |
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Authors:
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Petra E M van Schie; Maaike Schothorst; Annet J Dallmeijer; R Jeroen Vermeulen; Willem J R van Ouwerkerk; Rob L M Strijers; Jules G Becher |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of neurosurgery. Pediatrics Volume: 7 ISSN: 1933-0715 ISO Abbreviation: J Neurosurg Pediatr Publication Date: 2011 May |
Date Detail:
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Created Date: 2011-05-02 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101463759 Medline TA: J Neurosurg Pediatr Country: United States |
Other Details:
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Languages: eng Pagination: 557-62 Citation Subset: IM |
Affiliation:
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Departments of Rehabilitation Medicine. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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