Does gait continue to improve 2 years after selective dorsal rhizotomy?
Although changes in the gait pattern of children with spastic diplegia 1 year after selective dorsal rhizotomy have been well documented, minimal information exists regarding the continued changes in the gait pattern over time. Despite improvements in gait after rhizotomy, 66-75% of patients still require orthopaedic surgery for residual deformities. The optimal timing of the orthopaedic surgery after selective dorsal rhizotomy is not well established because of the lack of information regarding changes in gait over a long term. Using three-dimensional gait analysis, the gait pattern of 23 children was evaluated preoperatively, 1 and 2 years postoperatively. There were significant improvements in hip, knee, and ankle motion at 1 year after surgery. Although improvements in the gait pattern were found between 1 and 2 years after surgery, the changes were not significant. Therefore orthopaedic intervention may be undertaken at 1 year after rhizotomy to enhance function, as changes in gait from 1 to 2 years after rhizotomy are minimal.
Thomas
S S
SS
Shriners Hospital for Children, Portland, OR 97201, USA.
Aiona
M D
MD
Buckon
C E
CE
Piatt
J H
JH
D002547:Cerebral Palsy / Q000503:physiopathology / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D005684:Gait; D006801:Humans; D008297:Male; D018579:Patient Selection; D016059:Range of Motion, Articular; D019051:Rhizotomy / Q000592:standards*; D012399:Rotation; D013126:Spinal Nerve Roots / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome