Evaluation of satisfaction with surgical treatment for musculoskeletal dysfunction in children with cerebral palsy.
BACKGROUND
The variety of symptoms in cerebral palsy (CP) points to the advisability of using the term 'cerebral palsies' to underline the complex nature of the associated musculoskeletal dysfunctions. The incidence of CP is estimated at 1 to 5 in 1000 live born infants. This makes CP one of the main causes of hospitalization in paediatric orthopaedic wards. The complicated nature of the musculoskeletal dysfunctions entails the necessity of employing multiple surgical procedures: starting from multilevel soft tissue operations, to multiple corrective osteotomies, to spinal surgery with implantation of baclofen pumps for subarachnoid administration. The aim of the study was to evaluate the level of satisfaction following surgery in CP children.


METHODS
The study group was composed of 52 children (27 males and 25 females) surgically treated between 1988 and 2001. There were 18 children with hemiparesis, 19 with diparesis and 15 with tetraparesis. A subjective evaluation of the level of the satisfaction of the patient and the parent/guardian after the surgical treatment was carried out during a follow-up examination.


RESULTS
Forty-three parents (82.6%) reported improvement after the surgery and declared that they would take the same decision again. Five parents reported no significant change in the quality of life of their children (9.6%), and two (3.8%) reported a deterioration.


CONCLUSIONS
1. Multilevel soft tissue release in children with CP significantly improved their quality of life and was associated with a high level of parents'/guardians' satisfaction.
Borowski
Andrzej
A
Department of Orthopaedics and Paediatric Orthopaedics, Medical University of Łódź, Poland. aborowski@xl.wp.pl
Kwapisz
Adam
A
Dorman
Tomasz
T
Grzegorzewski
Andrzej
A
Synder
Marek
M
D000293:Adolescent; D002547:Cerebral Palsy / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D009128:Muscle Spasticity / Q000209:etiology / Q000601:surgery*; D017063:Outcome Assessment, Health Care; D010291:Paresis / Q000209:etiology / Q000601:surgery*; D017060:Patient Satisfaction; D011187:Posture; D011788:Quality of Life; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D055815:Young Adult