Multidimensional outcome measure of selective dorsal rhizotomy in spastic cerebral palsy

Elena Carraro, Sergio Zeme, Valentina Ticcinelli, Carlo Massaroni, Michela Santin, Paola Peretta, Andrea Martinuzzi, Enrico Trevisi

Research output: Contribution to journalArticle

Abstract

Background One of the treatment option to reduce spasticity in cerebral palsy children is selective dorsal rhizotomy. Several studies have demonstrated short and long term improvements in gait and other activities after rhizotomy but this surgery still remains a controversial procedure and patient outcome indicators measures are not uniform. Aims To describe our assessment and outcome evaluation protocol and to verify by this protocol short term results of rhizotomy.

Methods We recruited 9 cerebral palsy children (mean age 7.9 years ± 3.2) affected by mild to moderate spastic diplegia and operated by rhizotomy. Patients were studied preoperatively and at 12 months after surgery by the following clinical and instrumental measures correlated to the International Classification of Functioning: modified Ashworth Scale, passive Range of Motion, Medical Research Council Scale, Selective Motor Control Scale, 3D-motion analysis and energy cost of locomotion measurements (indicators of "body functions"); Gross Motor Functional Measure and Motor Functional Independence Measure (indicators of "activities and participation").

Results Our data showed, after rhizotomy, reduction of spasticity specially in plantarflexors muscles (p <0.01), increase of strength of knee flexors/extensors and foot plantar/dorsiflexion muscles (p <0.01), improvement of selective motor control (p <0.05), more similar spatio-temporal parameters of gait analysis to healthy subjects, reduced equinus foot and knees hyperflexion as energy cost.

Conclusion The complementary use of multiple indicators may improve the evaluation of the results of dorsal rhizotomy. A beneficial outcome measured by these indicators has been found in our spastic diplegic children one year after rhizotomy.

Original languageEnglish
Pages (from-to)704-713
Number of pages10
JournalEuropean Journal of Paediatric Neurology
Volume18
Issue number6
DOIs
Publication statusPublished - Nov 1 2014

Keywords

  • Cerebral palsy
  • Gait
  • Muscle spasticity
  • Oxygen consumption
  • Rhizotomy

ASJC Scopus subject areas

  • Clinical Neurology
  • Pediatrics, Perinatology, and Child Health
  • Medicine(all)

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