%0 Journal Article %1 O'Brien2005 %A O'Brien, Donncha F %A Park, Tae Sung %A Puglisi, Joan A %A Collins, David R %A Leuthardt, Eric C %A Leonard, Jeffrey R %D 2005 %J J Neurosurg %K Activities of Daily Living; Adolescent; Age Factors; Cerebral Pa; Child; Child, Preschool; Disabled Children; Follow-Up Studies; Humans; Orthopedic Procedures; Reoperation; Retrospective Rhizotomy; Walking; lsy %N 1 Suppl %P 5--9 %T Orthopedic surgery after selective dorsal rhizotomy for spastic diplegia in relation to ambulatory status and age. %V 103 %X OBJECT: A retrospective study was performed to determine the following: 1) whether children who walk independently after selective dorsal rhizotomy (SDR) undergo fewer subsequent orthopedic operations than those who walk with assistance; and 2) the effect of age at SDR on the rate of orthopedic operations. METHODS: The cases of 158 children with spastic diplegia who were 2 to 14 years of age when they underwent SDR were followed over a 5- to 9-year period. Patients were grouped by age at the time of SDR as follows: 2 to 3 years (Group 1), 4 to 7 years (Group 2), and 8 to 14 years (Group 3). Follow-up data showed that children in all age groups who walked independently after SDR underwent fewer orthopedic operations than did children who walked with assistance. Overall rates of orthopedic surgery 5 to 9 years after SDR at last follow up were 24\% for independent walkers and 51\% for assisted walkers. Two-way categorical analysis (age group by ambulation) yielded a highly significant effect of ambulation (p = 0.0003). Children in Group 1 needed the fewest orthopedic operations at follow-up evaluation. In the older age groups (Groups 2 and 3), those who walked independently at the time of SDR underwent fewer orthopedic operations after SDR than did walkers who required assistance (p = 0.01). CONCLUSIONS: These data are of value in advising parents about the likelihood of orthopedic surgery based on the child's gait status both at the time of SDR and at follow-up evaluation. Orthopedic surgery is more likely in patients destined to be nonambulators.

@article{O'Brien2005, abstract = {OBJECT: A retrospective study was performed to determine the following: 1) whether children who walk independently after selective dorsal rhizotomy (SDR) undergo fewer subsequent orthopedic operations than those who walk with assistance; and 2) the effect of age at SDR on the rate of orthopedic operations. METHODS: The cases of 158 children with spastic diplegia who were 2 to 14 years of age when they underwent SDR were followed over a 5- to 9-year period. Patients were grouped by age at the time of SDR as follows: 2 to 3 years (Group 1), 4 to 7 years (Group 2), and 8 to 14 years (Group 3). Follow-up data showed that children in all age groups who walked independently after SDR underwent fewer orthopedic operations than did children who walked with assistance. Overall rates of orthopedic surgery 5 to 9 years after SDR at last follow up were 24\% for independent walkers and 51\% for assisted walkers. Two-way categorical analysis (age group by ambulation) yielded a highly significant effect of ambulation (p = 0.0003). Children in Group 1 needed the fewest orthopedic operations at follow-up evaluation. In the older age groups (Groups 2 and 3), those who walked independently at the time of SDR underwent fewer orthopedic operations after SDR than did walkers who required assistance (p = 0.01). CONCLUSIONS: These data are of value in advising parents about the likelihood of orthopedic surgery based on the child's gait status both at the time of SDR and at follow-up evaluation. Orthopedic surgery is more likely in patients destined to be nonambulators.}, added-at = {2014-07-19T20:56:32.000+0200}, author = {O'Brien, Donncha F and Park, Tae Sung and Puglisi, Joan A and Collins, David R and Leuthardt, Eric C and Leonard, Jeffrey R}, biburl = {https://www.bibsonomy.org/bibtex/2fd403abb7c91c4f936a5dac706c7d150/ar0berts}, groups = {public}, interhash = {1a9561d5bb4ef526a7403feeab915c2f}, intrahash = {fd403abb7c91c4f936a5dac706c7d150}, journal = {J Neurosurg}, keywords = {Activities of Daily Living; Adolescent; Age Factors; Cerebral Pa; Child; Child, Preschool; Disabled Children; Follow-Up Studies; Humans; Orthopedic Procedures; Reoperation; Retrospective Rhizotomy; Walking; lsy}, month = Jul, number = {1 Suppl}, pages = {5--9}, pmid = {16121998}, timestamp = {2014-07-19T20:56:32.000+0200}, title = {Orthopedic surgery after selective dorsal rhizotomy for spastic diplegia in relation to ambulatory status and age.}, username = {ar0berts}, volume = 103, year = 2005 }