Simultaneous femoral derotation osteotomy and selective dorsal rhizotomy in children with spastic cerebral palsy: A prospective follow-up of 3 cases

Abstract

Cerebral palsy (CP) refers to a group of neurodevelopmental disorders characterized by permanent motor impairment, sometimes associated with comorbidities, such as seizures, intellectual disability, speech, visual and hearing difficulties. It is caused by lesions in the developing brain that occur before, during or in the first two years after birth. CP is the most common cause for disability in children [1,2]. Different neuromotor types of CP are described, with the bilateral spastic subtype as the most frequent manifestation [3]. Spasticity is an important clinical aspect that affects motion patterns and muscular control. Furthermore, it is generally considered to be a crucial contributor to functional limitations, discomfort and gait abnormalities [4]. The supposed pathophysiology is an excessive afferent input onto intramedullary neurons without the expected inhibitory signals from the corticospinal tract, which is disrupted in case of CP associated cerebral