title: Single Event Multilevel Surgery in children with bilateral spastic cerebral palsy: a 5 year prospective cohort study.
abstract: BACKGROUND
  Single Event Multilevel Surgery (SEMLS) is considered the standard of care to improve gait and function in children with bilateral spastic cerebral palsy (BSCP). We have demonstrated in a randomized controlled trial (RCT) of SEMLS, that gait was improved at 12 months after surgery and gross motor function at 24 months after surgery. The question addressed in this study, was to determine if improvements in gait and function, would be maintained at 5 year follow-up.
  
  
  METHODS
  Nineteen children with BSCP, GMFCS levels II (14 children) and III (5 children), mean age 9.7 years (range 7.7-12.2 years) participated in a prospective cohort study following participation in a RCT, with follow-up to 5 years. Outcome measures were Gait Profile Score (GPS), Gillette Gait Index (GGI), Gait Deviation Index (GDI), Gross Motor Function Measure (GMFM66) and Functional Mobility Scale (FMS).
  
  
  RESULTS
  Eighteen children have completed follow-up, with interval analysis at 1, 2 and 5 years post SEMLS. One child was excluded because of neurological deterioration and his diagnosis was revised to Hereditary Spastic Paraparesis (HSP). GPS improved by 5.29° and GMFM66 by 3.3% at 5 years post SEMLS. Differences between outcome measures at 1 versus 5 years and 2 versus 5 years (except GMFM66) were not significant, indicating that improvements in gait and gross motor function were stable over time.
  
  
  CONCLUSIONS
  SEMLS results in clinically and statistically significant improvements in gait and function, in children with BSCP, which were maintained at 5 years after surgery.
authors: Hugh Williamson Gait Analysis Laboratory, Royal Children's Hospital, Melbourne, Australia. pam.thomason@rch.org.au
authors: Pam
authors: P
authors: Thomason
authors: Paulo
authors: P
authors: Selber
authors: H Kerr
authors: HK
authors: Graham
mesh_terms: D002547:Cerebral Palsy / Q000534:rehabilitation / Q000601:surgery*; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D005684:Gait; D006801:Humans; D008297:Male; D009048:Motor Skills; D009128:Muscle Spasticity / Q000534:rehabilitation / Q000601:surgery; D019637:Orthopedic Procedures; D011627:Puberty; D016032:Randomized Controlled Trials as Topic; D016059:Range of Motion, Articular; D013997:Time Factors; D016896:Treatment Outcome