title: Impact of selective posterior rhizotomy on fine motor skills. Long-term results using a validated evaluative measure.
abstract: Suprasegmental effects following selective posterior rhizotomy have been frequently reported. However, few studies have used validated functional outcome measures to report the surgical results beyond 3 years. The authors analyzed data obtained from the McGill Rhizotomy Database to determine the long-term impact of lumbosacral dorsal rhizotomy on fine motor skills. The study population comprised children with debilitating spasticity who underwent SPR and were evaluated by a multidisciplinary team preoperatively, at 6 months and 1 year postoperatively. Quantitative standardized assessments of upper extremity function were obtained using the fine motor skills section of the Peabody Developmental Motor Scales (PDMS) test. Of 70 patients who met the entry criteria for the study, 45 and 25 completed the 3- and 5-year assessments, respectively. Statistical analysis demonstrated significant improvements in grasping, hand use, eye-hand coordination, and manual dexterity at 1 year after SPR. More importantly, all improvements were maintained at 3 and 5 years following SPR. This study supports that significant improvements in upper extremity fine motor function using the PDMS evaluative measure are present after SPR and that these suprasegmental benefits are durable.
authors.affiliation: Division of Neurosurgery, Montreal Children's Hospital, McGill University Health Centre, Montreal, P.Q., Canada.
authors.forename: Sandeep
authors.initials: S
authors.lastname: Mittal
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Farmer
authors.forename: Borhan
authors.initials: B
authors.lastname: Al-Atassi
authors.forename: Kathleen
authors.initials: K
authors.lastname: Montpetit
authors.forename: Nathalie
authors.initials: N
authors.lastname: Gervais
authors.forename: Chantal
authors.initials: C
authors.lastname: Poulin
authors.forename: Marie-André
authors.initials: MA
authors.lastname: Cantin
authors.forename: Thierry E
authors.initials: TE
authors.lastname: Benaroch
mesh_terms: D002547:Cerebral Palsy / Q000145:classification / Q000503:physiopathology* / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D009048:Motor Skills; D009128:Muscle Spasticity; D019637:Orthopedic Procedures; D019051:Rhizotomy / Q000379:methods*; D016896:Treatment Outcome