Effect of selective dorsal rhizotomy in the treatment of children with cerebral palsy.
OBJECTIVE
In this investigation the authors compared impairment and functional outcomes between two groups of children with cerebral palsy (CP): one group underwent selective dorsal rhizotomy (SDR) followed by intensive physical therapy (PT), and the other group underwent the latter only (PT group). Data from an age-matched group of children without disability (nondisabled [ND] group) were also collected.


METHODS
Data pertaining to the 68 children with CP were collected before any intervention and again 8 and 20 months afterwards. Data regarding the 40 children in the ND group were collected in a single session.


CONCLUSIONS
Although patients in both groups with CP were weaker than those in the ND group, they did have strength gains. Gait speed in the SDR-PT group was slower than that in the ND group preoperatively but not at 20 months postoperatively. Gait speed in the PT group remained slower than that in the ND group. The pre- to postoperative change in the Gross Motor Abilities Estimate score was significantly greater in the SDR-PT group than in the PT-only group. An effective treatment for children with CP, SDR offers gains in strength, gait speed, and overall gross motor function.
Engsberg
Jack R
JR
Department of Neurological Surgery, Human Performance Laboratory, Center for Cerebral Palsy Spasticity, St. Louis Children's Hospital, Missouri, USA. jengsber@slu.edu
Ross
Sandy A
SA
Collins
David R
DR
Park
Tae Sung
TS
D000293:Adolescent; D002547:Cerebral Palsy / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005260:Female; D005684:Gait / Q000502:physiology; D006801:Humans; D008297:Male; D009128:Muscle Spasticity / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D018482:Muscle, Skeletal / Q000503:physiopathology; D026741:Physical Therapy Modalities; D019051:Rhizotomy; D013126:Spinal Nerve Roots / Q000601:surgery*; D016896:Treatment Outcome