Effects of selective dorsal rhizotomy on gait in children with cerebral palsy.
We wished to examine the effects of selective dorsal rhizotomy (SDR) on the gait patterns of children with cerebral palsy (CP). Nineteen ambulatory children underwent preoperative and 1-year postoperative gait analyses that included clinical assessment of joint range of motion (ROM) and muscle tone, three-dimensional motion analysis, and dynamic electromyography (EMG). The children were divided into two groups: independent ambulators (n = 11) and dependent ambulators (requiring a walking aid) (n = 8). Improvements in joint passive ROM and a reduction in lower extremity spasticity were noted. In both groups, positive pre- to postoperative improvements were noted in sagittal plane hip, knee, and ankle motion and there was a greater incidence of a plantar-grade foot position in stance. There was no change in the coronal plane motion of the pelvis and hip. A mean increase in anterior pelvic tilt for the independent ambulators was the only major negative change observed in this study. We conclude that SDR improves specific gait parameters in children with CP.
Boscarino
L F
LF
Gait Analysis Laboratory, Newington Children's Hospital, Connecticut.
Ounpuu
S
S
Davis
R B
RB
Gage
J R
JR
DeLuca
P A
PA
D000843:Ankle Joint / Q000503:physiopathology; D002547:Cerebral Palsy / Q000503:physiopathology* / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D004576:Electromyography; D005260:Female; D005684:Gait; D005727:Ganglia, Spinal / Q000601:surgery*; D006621:Hip Joint / Q000503:physiopathology; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology; D008297:Male; D009128:Muscle Spasticity; D016059:Range of Motion, Articular; D016896:Treatment Outcome