%0 Journal Article %1 Mittal2002a %A Mittal, Sandeep %A Farmer, Jean-Pierre %A Al-Atassi, Borhan %A Gibis, Joanne %A Kennedy, Eileen %A Galli, Carlo %A Courchesnes, Guylaine %A Poulin, Chantal %A Cantin, Marie-Andr? %A Benaroch, Thierry E %D 2002 %J J Neurosurg %K Cerebral Palsy; Child; Child, Preschool; Electrophysiology; Female; Humans; Leg; Male; Monitoring, Intraoperative; Motor Activity; Muscle, Skeletal; Outcome Assessment (Health Care); Posterior Horn Cells; Prospective Studies; Range of Motion, Articular; Recovery Function; Rhizotomy; Time Factors %N 2 %P 315--325 %T Long-term functional outcome after selective posterior rhizotomy. %V 97 %X OBJECT: Selective posterior rhizotomy (SPR) is a well-recognized treatment for children with spastic cerebral palsy (CP). Few investigators have used quantitative outcome measures to assess the surgical results beyond 3 years. The authors analyzed data obtained from the McGill Rhizotomy Database to determine the long-term functional outcome of children who had undergone selective dorsal rhizotomy accompanied by intraoperative electrophysiological monitoring. METHODS: The study population was composed of children with spastic CP who underwent SPR and were evaluated by a multidisciplinary team preoperatively, and at 6 months and 1 year postoperatively. Quantitative standardized assessments of lower-limb spasticity, passive range of motion, muscle strength, and ambulatory function were obtained. Of the 93 patients who met the entry criteria for the study, 71 completed the 3-year and 50 completed the 5-year assessments, respectively. Statistical analysis demonstrated significant improvements in spasticity, range of motion, and functional muscle strength at 1 year after SPR. The preoperative, 1-, 3-, and 5-year values for the global score of the Gross Motor Function Measure were 64.6, 70.8, 80, and 85.6, respectively. The greatest improvement occurred in the dimensions reflecting lower-extremity motor function, where the mean change was 10.1\% at 1 year, 19.9\% at 3 years, and 34.4\% at the 5-year follow-up review in comparison with the baseline value. This was associated with a lasting improvement in alignment and postural stability during developmental positions, as well as increased ability to perform difficult transitional movements. CONCLUSIONS: The results of this study support the presence of significant improvements in lower-limb functional motor outcome 1 year after SPR, and the improvements persist at 3 and 5 years. The authors conclude that SPR in conjunction with intraoperative stimulation is valuable for permanently alleviating lower-limb spasticity while augmenting motor function.

@article{Mittal2002a, abstract = {OBJECT: Selective posterior rhizotomy (SPR) is a well-recognized treatment for children with spastic cerebral palsy (CP). Few investigators have used quantitative outcome measures to assess the surgical results beyond 3 years. The authors analyzed data obtained from the McGill Rhizotomy Database to determine the long-term functional outcome of children who had undergone selective dorsal rhizotomy accompanied by intraoperative electrophysiological monitoring. METHODS: The study population was composed of children with spastic CP who underwent SPR and were evaluated by a multidisciplinary team preoperatively, and at 6 months and 1 year postoperatively. Quantitative standardized assessments of lower-limb spasticity, passive range of motion, muscle strength, and ambulatory function were obtained. Of the 93 patients who met the entry criteria for the study, 71 completed the 3-year and 50 completed the 5-year assessments, respectively. Statistical analysis demonstrated significant improvements in spasticity, range of motion, and functional muscle strength at 1 year after SPR. The preoperative, 1-, 3-, and 5-year values for the global score of the Gross Motor Function Measure were 64.6, 70.8, 80, and 85.6, respectively. The greatest improvement occurred in the dimensions reflecting lower-extremity motor function, where the mean change was 10.1\% at 1 year, 19.9\% at 3 years, and 34.4\% at the 5-year follow-up review in comparison with the baseline value. This was associated with a lasting improvement in alignment and postural stability during developmental positions, as well as increased ability to perform difficult transitional movements. CONCLUSIONS: The results of this study support the presence of significant improvements in lower-limb functional motor outcome 1 year after SPR, and the improvements persist at 3 and 5 years. The authors conclude that SPR in conjunction with intraoperative stimulation is valuable for permanently alleviating lower-limb spasticity while augmenting motor function.}, added-at = {2014-07-19T20:48:15.000+0200}, author = {Mittal, Sandeep and Farmer, Jean-Pierre and Al-Atassi, Borhan and Gibis, Joanne and Kennedy, Eileen and Galli, Carlo and Courchesnes, Guylaine and Poulin, Chantal and Cantin, Marie-Andr? and Benaroch, Thierry E}, biburl = {https://www.bibsonomy.org/bibtex/24ab81ec51fc4c83f3230b820e15f8fc5/ar0berts}, groups = {public}, interhash = {37dc975fa6fed7b68438577184cb8799}, intrahash = {4ab81ec51fc4c83f3230b820e15f8fc5}, journal = {J Neurosurg}, keywords = {Cerebral Palsy; Child; Child, Preschool; Electrophysiology; Female; Humans; Leg; Male; Monitoring, Intraoperative; Motor Activity; Muscle, Skeletal; Outcome Assessment (Health Care); Posterior Horn Cells; Prospective Studies; Range of Motion, Articular; Recovery Function; Rhizotomy; Time Factors}, month = Aug, number = 2, pages = {315--325}, pmid = {12186459}, timestamp = {2014-07-19T20:48:15.000+0200}, title = {Long-term functional outcome after selective posterior rhizotomy.}, username = {ar0berts}, volume = 97, year = 2002 }