Gillespie, Conor S;
Hall, Benjamin J;
George, Alan M;
Hennigan, Dawn;
Sneade, Christine;
Cawker, Stephanie;
Silva, Adikarige Haritha Dulanka;
... Pettorini, Benedetta; + view all
(2024)
Selective dorsal rhizotomy in non-ambulant children with cerebral palsy: a multi-center prospective study.
Child's Nervous System
, 40
(1)
pp. 171-180.
10.1007/s00381-023-06062-4.
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Abstract
Purpose: Assess the effects of selective dorsal rhizotomy (SDR) on motor function and quality of life in children with a Gross Motor Function Classification System (GMFCS) level of IV or V (non-ambulatory). Methods: This is a prospective, observational study in three tertiary neurosurgery units in England, UK, performing SDR on children aged 3–18 with spastic diplegic cerebral palsy, and a GMFCS level of IV or V, between 2012 and 2019. The primary outcome measure was the change in the 66-item Gross Motor Function Measure (GMFM-66) from baseline to 24 months after SDR, using a linear mixed effects model. Secondary outcomes included spasticity, bladder function, quality of life, and pain scores. Results: Between 2012 and 2019, 144 children who satisfied these inclusion criteria underwent SDR. The mean age was 8.2 years. Fifty-two percent were female. Mean GMFM-66 score was available in 77 patients (53.5%) and in 39 patients (27.1%) at 24 months after SDR. The mean increase between baseline and 24 months post-SDR was 2.4 units (95% CI 1.7–3.1, p < 0.001, annual change 1.2 units). Of the 67 patients with a GMFM-66 measurement available, a documented increase in gross motor function was seen in 77.6% (n = 52). Of 101 patients with spasticity data available, mean Ashworth scale decreased after surgery (2.74 to 0.30). Of patients’ pain scores, 60.7% (n = 34) improved, and 96.4% (n = 56) of patients’ pain scores remained the same or improved. Bladder function improved in 30.9% of patients. Conclusions: SDR improved gross motor function and reduced pain in most patients at 24 months after surgery, although the improvement is less pronounced than in children with GMFCS levels II and III. SDR should be considered in non-ambulant patients.
| Type: | Article |
|---|---|
| Title: | Selective dorsal rhizotomy in non-ambulant children with cerebral palsy: a multi-center prospective study |
| Location: | Germany |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1007/s00381-023-06062-4 |
| Publisher version: | https://doi.org/10.1007/s00381-023-06062-4 |
| Language: | English |
| Additional information: | © 2025 Springer Nature. This article is licensed under a Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/). |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Developmental Neurosciences Dept |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10214161 |
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