A review of orthopedic surgeries after selective dorsal rhizotomy.
Selective dorsal rhizotomy (SDR) is an evidence-based treatment for cerebral palsy (CP) spasticity. During their lifetime, patients with CP spasticity may require orthopedic surgery for muscles and joints to correct physical deformities and provide a better quality of life. In this review, the authors discuss the timing of such orthopedic surgery, its necessity, and whether it is influenced by the performance of SDR. A review of findings from the authors' 19 years of experience yields the following conclusions: 1) that SDR reduces orthopedic surgery requirements when compared with historical controls; 2) that SDR performed in patients at a young age (2-4 years) can reduce future orthopedic surgery requirements; 3) that independent walkers and diplegic patients will have the smallest amount of orthopedic surgery post-SDR; and 4) that patients who need assistance walking and those with quadriplegia will have the greatest amount, although the frequency of orthopedic surgery for quadriplegic patients is not as high as popularly believed.
O'Brien
Donncha F
DF
Department of Neurosurgery, St. Louis Children's Hospital, Washington University School of Medicine, St. Louis, Missouri, USA.
Park
Tae Sung
TS
D002547:Cerebral Palsy / Q000150:complications / Q000601:surgery*; D006801:Humans; D009128:Muscle Spasticity / Q000209:etiology / Q000601:surgery; D009985:Orthopedics / Q000379:methods*; D019051:Rhizotomy / Q000379:methods*; D016896:Treatment Outcome