Selective posterior rhizotomy: a long-term follow-up study

Arens, Leila J.; Peacock, Warwick J.; Peter, Jonathan C.

doi:10.1007/bf00272116

Cited by 108 publications

(55 citation statements)

References 3 publications

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“…Peacock et al [6]applied this procedure initially to 60 children in Cape Town with spastic cerebral palsy who where followed for up to 7 years postoperatively. Reduced spasticity and functional gains were reported [6, 26, 27, 28]. In a subsequent series, Peacock and Staudt [29]observed decreased muscle tone, an increased range of motion and improved gait using objective measurements.…”

Section: The History Of Rhizotomy For the Treatment Of Spasticitymentioning

confidence: 92%

“…Sensory loss and transient hyperesthesias are often seen after selective posterior rhizotomy, but can be minimized when the percentage of nerve rootlets sectioned is kept to a minimum. In the Cape Town series with a 7-year follow-up, only 3 out of 51 patients had a clinically detectable decrease in sensation [26]. Persistent sensory loss of no clinical significance was noted in 3.8% of patients in another report [62].…”

Section: Complications Of Rhizotomymentioning

confidence: 99%

“…Video recordings and instrumented gait analysis were first performed on these patients [6, 27, 28, 34, 35]. The results of long-term follow-up of 51 children with spastic cerebral palsy 3–7 years after posterior rhizotomy showed that spasticity remained reduced in all patients, motor function improved in 80%, sensory disturbances were insignificant and 47% required orthopedic procedures [26]. Thomas et al [36]found that 66–75% of their patients with spastic diplegia required orthopedic surgery following posterior rhizotomy.…”

Section: Outcomes Of Posterior Rhizotomymentioning

confidence: 99%

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Selective Posterior Rhizotomy and Intrathecal Baclofen for the Treatment of Spasticity

et al. 2001

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Spasticity occurs in children and adults due to a wide range of conditions, including cerebral palsy, head and spinal cord trauma, cerebrovascular accidents and multiple sclerosis. Multiple treatment options have been described, including medical and surgical treatments. Medical treatments include intramuscular botulinum A toxin, oral baclofen and supportive bracing. Surgical approaches include selective posterior rhizotomy, intrathecal baclofen and orthopedic procedures to address deformities. Many reports have been published on these different treatment options, but rarely has a comparison been made between them. Therefore, this review is aimed at comparing selective posterior rhizotomy and intrathecal baclofen injection for spasticity due to cerebral palsy, especially in children.

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Section: The History Of Rhizotomy For the Treatment Of Spasticitymentioning

confidence: 92%

Section: Complications Of Rhizotomymentioning

confidence: 99%

Section: Outcomes Of Posterior Rhizotomymentioning

confidence: 99%

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Selective Posterior Rhizotomy and Intrathecal Baclofen for the Treatment of Spasticity

et al. 2001

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“…2,11,14,15 It reduces spasticity by decreasing the excitatory input entering the spinal cord after the transection of selected sensory nerves of the cauda equina. 19 Class I evidence supports the utility of SDR for the immediate and permanent reduction of spastic diplegia in patients with cerebral palsy, improving motor function and performance of ADL.…”

Section: 14mentioning

confidence: 99%

Role of dorsal rhizotomy in spinal cord injury–induced spasticity

Reynolds

Morton

Walker

et al. 2014

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Selective dorsal rhizotomy may have a role in the management of spinal cord injury (SCI)–induced spasticity. Spasticity and spasms are common sequelae of SCI in children. Depending on the clinical scenario, treatments may include physical and occupational therapy, oral medications, chemodenervation, and neurosurgical interventions. Selective dorsal rhizotomy (SDR) is used in the management of spasticity in selected children with cerebral palsy, but, to the authors' knowledge, its use has not been reported in children with SCI. The authors describe the cases of 3 pediatric patients with SCI and associated spasticity treated with SDR. Two of the 3 patients have had significant long-term improvement in their preoperative spasticity. Although the third patient also experienced initial relief, his spasticity quickly returned to its preoperative severity, necessitating additional therapies. Selective dorsal rhizotomy may have a place in the treatment of selected children with spasticity due to SCI.

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“…We have shown that 5 years after surgery, over 80% of 51 patients were still making progress, [1] whereas at 10 years, 97 of 110 patients had improved their patterns of ambulation, although a formal gait analysis was not conducted. [26] Fasano and Broggi [12] have provided anecdotal evidence of functional benefits 15 years after SDR for 80 patients.…”

mentioning

confidence: 99%

Gait before and 10 years after rhizotomy in children with cerebral palsy spasticity

Subramanian¹,

Vaughan²,

Peter³

et al. 1998

FOC

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Selective dorsal rhizotomy is a neurosurgical procedure performed for the relief of spasticity in children with cerebral palsy, but its long-term functional efficacy is still unknown. The authors sought to address this issue by means of an objective, prospective study in which quantitative gait analysis was used. Eleven children with spastic diplegia (mean age at initial surgery 7.8 years) were evaluated preoperatively in 1985 and then at 1, 3, and at least 10 years after surgery. For comparison, 12 age-matched normal individuals were also studied. Retroreflective targets were placed over the hip, knee, and ankle joints, and each individual's gait was videotaped. The video data were subsequently entered into a computer for extraction and analysis of the gait parameters. An analysis of variance yielded a significant time effect (p < 0.05), and post hoc comparisons revealed differences before and after surgery and with respect to the normal control subjects. The knee and hip ranges of motion (59š and 44š, respectively, for controls) were significantly restricted prior to surgery (41š and 41š, respectively), but were within normal limits after 10 years (52š and 45š, respectively). The knee and hip midrange values (31š and 3š, respectively, for controls), indicative of posture, were significantly elevated preoperatively (42š and 15š) and increased sharply at 1 year (56š and 18š), but by 10 years they had decreased to within normal limits (36š and 9š). Step length and velocity improved postoperatively but were not within the normal range after 10 years. Ten years after surgery our patients not only had increased ranges of motion, they also used that movement about a normal midrange point. Selective dorsal rhizotomy is an effective method for alleviating spasticity; furthermore, the authors provide evidence to show that lasting functional benefits, as measured by improved gait, can also be obtained.

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Selective posterior rhizotomy: a long-term follow-up study

Cited by 108 publications

References 3 publications

Selective Posterior Rhizotomy and Intrathecal Baclofen for the Treatment of Spasticity

Selective Posterior Rhizotomy and Intrathecal Baclofen for the Treatment of Spasticity

Role of dorsal rhizotomy in spinal cord injury–induced spasticity

Gait before and 10 years after rhizotomy in children with cerebral palsy spasticity

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