Selective dorsal rhizotomy: outcome and complications in treating spastic cerebral palsy.
Selective dorsal rhizotomy has shown great promise as a treatment for the functional disabilities and deforming hypertonia of spastic cerebral palsy. At New York University Medical Center, 200 children underwent this procedure between 1986 and 1990. All groups, whether walkers, crawlers, or nonlocomotors, showed improvement in the tone and range of most muscles tested. Half of these patients experienced complications. Thirty-five of these were serious and included bronchospasm (5.5%), aspiration pneumonia (3.5%), urinary retention (7%), and sensory loss (2%). There are, however, clear indications that warn of these complications; monitoring and prophylactic treatment can minimize their effects, and the possibility of such problems is more than offset by the proven benefits of this operative procedure.
Abbott
R
R
Department of Neurosurgery, New York University Medical Center, New York.
Johann-Murphy
M
M
Shiminski-Maher
T
T
Quartermain
D
D
Forem
S L
SL
Gold
J T
JT
Epstein
F J
FJ
D002547:Cerebral Palsy / Q000503:physiopathology / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D004185:Disability Evaluation; D004576:Electromyography; D005260:Female; D006801:Humans; D008124:Locomotion / Q000502:physiology; D008297:Male; D009128:Muscle Spasticity / Q000503:physiopathology / Q000601:surgery*; D009132:Muscles / Q000294:innervation; D009460:Neurologic Examination; D011183:Postoperative Complications / Q000503:physiopathology; D016059:Range of Motion, Articular / Q000502:physiology; D013126:Spinal Nerve Roots / Q000503:physiopathology / Q000601:surgery*