Spinal Stenosis after Total Lumbar Laminectomy for Selective Dorsal Rhizotomy

Gooch, Judith L.; Walker, Marion L.

doi:10.1159/000121092

Cited by 14 publications

(6 citation statements)

References 2 publications

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“…Spinal deformity is the most commonly reported long‐term complication, with increased risks of lumbar lordosis, scoliosis, spinal stenosis, and spondylolisthesis …”

Section: Resultsmentioning

confidence: 99%

“…The major late complication observed in this review, reported in 11% to 57% of all individuals, is spinal deformity, although most of the case series involved X-ray follow-up at a time-point clearly before skeletal maturity. 9,[25][26][27][29][30][31][32][33]38,39,48,49 The highest risk of skeletal deformity occurs during adolescent growth. Therefore, any reports of a risk of developing deformity should include a radiological evaluation at skeletal maturity.…”

Section: Discussionmentioning

confidence: 99%

“…S2). The procedure for reviewing the 24 included reports was similar to that described above, except that in these cases, neither risk of bias nor level of evidence was assessed (Table ).…”

Section: Methodsmentioning

confidence: 99%

“…Spinal deformity is the most commonly reported long-term complication, with increased risks of lumbar lordosis, 9,25,26,29,30,32,33,38,48 scoliosis, 9,32,33,[37][38][39]48 spinal stenosis, 27,30 and spondylolisthesis. 9,29,31,32,37,40,41,44,48,49 Loss of motor function…”

Section: Spinal Deformitymentioning

confidence: 99%

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Long‐term effects of selective dorsal rhizotomy in children with cerebral palsy: a systematic review

Tedroff

Hägglund

Miller

2019

Develop Med Child Neuro

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Aim To evaluate the long‐term effects of selective dorsal rhizotomy (SDR) 10 years or more after the procedure and complications observed any time after SDR in children with cerebral palsy (CP). Method Embase, PubMed, and the Cochrane Library were searched from their individual dates of inception through 1st June 2018 for full‐text original articles in English that described long‐term follow‐up after SDR in children with CP. The authors independently screened publications to determine whether they met inclusion criteria; thereafter all authors extracted data on patient characteristics, the proportion of the original cohort being followed‐up, and the reported outcomes. Results Of the 199 studies identified, 16 were included in this evaluation: 14 were case series and two studies reported a retrospectively assigned comparison group. Evidence concerning function was limited by study design differences, clinical variability, loss to follow‐up, and heterogeneity across trials. Interpretation At 10 years or more follow‐up, available studies generate low‐level evidence with considerable bias. No functional improvement of SDR over routine therapy is documented. Furthermore, the long‐term effects of SDR with respect to spasticity reduction is unclear, with many studies reporting a high amount of add‐on spasticity treatment. More long‐term follow‐up using robust scientific protocols is required before it can be decided whether the use of SDR as routine therapy for children with CP is to be recommended or not. What this paper adds Ten years after selective dorsal rhizotomy, available studies supply inconclusive evidence on functional outcomes. The long‐term effect on spasticity is uncertain, studies reported a substantial need for add‐on treatment. Short‐ and long‐term complications seem frequent but are not reported in a consistent manner.

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“…Spinal deformity is the most commonly reported long‐term complication, with increased risks of lumbar lordosis, scoliosis, spinal stenosis, and spondylolisthesis …”

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…S2). The procedure for reviewing the 24 included reports was similar to that described above, except that in these cases, neither risk of bias nor level of evidence was assessed (Table ).…”

Section: Methodsmentioning

confidence: 99%

Section: Spinal Deformitymentioning

confidence: 99%

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Long‐term effects of selective dorsal rhizotomy in children with cerebral palsy: a systematic review

Tedroff

Hägglund

Miller

2019

Develop Med Child Neuro

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“…Scoliosis, kyphosis or lordosis was no more prevalent in rhizotomy patients than in cerebral palsy patients in general [64]. Spinal stenosis was seen in 1.5% of patients after multilevel laminectomy or laminotomy for dorsal rhizotomy [66]. Park [67]described no spinal complications in 542 patients since 1991 after a limited laminectomy.…”

Section: Complications Of Rhizotomymentioning

confidence: 99%

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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