Document Detail


The use of minimally invasive techniques in multi-level surgery for children with cerebral palsy: preliminary results.
MedLine Citation:
PMID:  20884985     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This study compares the initial outcomes of minimally invasive techniques for single-event multi-level surgery with conventional single-event multi-level surgery. The minimally invasive techniques included derotation osteotomies using closed corticotomy and fixation with titanium elastic nails and percutaneous lengthening of muscles where possible. A prospective cohort study of two matched groups was undertaken. Ten children with diplegic cerebral palsy with a mean age of ten years six months (7.11 to 13.9) had multi-level minimally invasive surgery and were matched for ambulatory level and compared with ten children with a mean age of 11 years four months (7.9 to 14.4) who had conventional single-event multi-level surgery. Gait kinematics, the Gillette Gait Index, isometric muscle strength and gross motor function were assessed before and 12 months after operation. The minimally invasive group had significantly reduced operation time and blood loss with a significantly improved time to mobilisation. There were no complications intra-operatively or during hospitalisation in either group. There was significant improvement in gait kinematics and the Gillette Gait Index in both groups with no difference between them. There was a trend to improved muscle strength in the multi-level group. There was no significant difference in gross motor function between the groups. We consider that minimally invasive single-event multi-level surgery can be achieved safely and effectively with significant advantages over conventional techniques in children with diplegic cerebral palsy.
Authors:
N Thompson; J Stebbins; M Seniorou; A M Wainwright; D J Newham; T N Theologis
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Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of bone and joint surgery. British volume     Volume:  92     ISSN:  0301-620X     ISO Abbreviation:  J Bone Joint Surg Br     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-04     Completed Date:  2010-11-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0375355     Medline TA:  J Bone Joint Surg Br     Country:  England    
Other Details:
Languages:  eng     Pagination:  1442-8     Citation Subset:  AIM; IM    
Affiliation:
Oxford Gait Laboratory, Nuffield Orthopaedic Centre, Headington, Oxford OX3 7LD, UK. nicky.thompson@noc.nhs.uk
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Blood Loss, Surgical
Cerebral Palsy / physiopathology,  surgery*
Child
Early Ambulation
Female
Femur / radiography,  surgery
Gait
Hip Joint / physiopathology
Humans
Intraoperative Period
Knee Joint / physiopathology
Male
Muscle Strength
Pilot Projects
Prospective Studies
Surgical Procedures, Minimally Invasive / methods,  rehabilitation
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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