[The results of single-event multilevel orthopedic surgeries and the early rehabilitation used in complex with botulinum toxin treatment in patients with spastic forms of cerebral palsy].
OBJECTIVE
To evaluate motor possibilities of patients with children spastic palsy (CSP) one year after single-event multilevel orthopedic low extremity surgeries in combination with early rehabilitation treatment including botulinum toxin treatment.


METHODS
Authors studied the results of operative orthopedic treatment in 55 patients with CSP, aged from 5 to 17 years (mean 11.9 ± 2.5 years), who underwent multilevel surgeries with early functional rehabilitation using 1.5 treatment courses with 6-8 week treatment-free periods during 9-12 months in combination with a single injection of disport in the post-operative period. We performed 74 surgeries 140 episodes of botulinum toxin treatment using average doses of Botulinum toxin 10 U per kg of body mass injected into low extremity muscles.


RESULTS
In the post-operative period, authors recorded a significant reduction in pain syndrome, assessed with a pain intensity scale, from 8.6 ± 1.2 to 4.3 ± 1.1 scores (p < 0.001). An analysis of gait demonstrated an improvement of gait patterns in all patients able to move independently. An increase in motor abilities, measured with the Gillette Functional Assessment Questionnaire, by 1 level was identified in 28 (50.9%) patients, by 2 levels in 2 (3.6%) patients, no changes were observed in 25 (45.5%) patients.


CONCLUSIONS
Single-event multilevel orthopedic surgeries in children with CSP reduce a number of repeated surgeries. The effective control over pain syndrome in patients with CSP using multilevel botulinum toxin treatment in the post-operative period promotes the functional rehabilitation, increases rates of loading during training sessions and the motivation of CSP patients to restore the lost activity.
Russian Ilizarov Scintific Center for Restorative Traumatology and Orthopaedics of the RF Ministry of Health, Kurgan.
D A
DA
Popkov
Center for Restorative Treatment and Rehabilitation 'Nadezda', Tumen.
V A
VA
Zmanovskaya
Kurgan Regional Children Hospital Named after Red Cross, Kurgan.
E B
EB
Gubina
Russian Ilizarov Scintific Center for Restorative Traumatology and Orthopaedics of the RF Ministry of Health, Kurgan.
S S
SS
Leonchuk
Center for Restorative Treatment and Rehabilitation 'Nadezda', Tumen.
M N
MN
Butorina
Center for Restorative Treatment and Rehabilitation 'Nadezda', Tumen.
O L
OL
Pavlova
D000293:Adolescent; D001905:Botulinum Toxins / Q000008:administration & dosage / Q000627:therapeutic use*; D002547:Cerebral Palsy / Q000188:drug therapy / Q000534:rehabilitation* / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D009043:Motor Activity; D009128:Muscle Spasticity / Q000188:drug therapy / Q000534:rehabilitation / Q000601:surgery; D019637:Orthopedic Procedures; D016896:Treatment Outcome; D016138:Walking
D001905:Botulinum Toxins