The Functional Outcome of Single Stage Multi-Level Surgery of Spastic Cerebral Palsy

Abstract

Introduction: Cerebral palsy is a heterogeneous disorder that makes the child handicapped. The incidence is about 2 per 1000 live births with the highest rates in premature babies and those of multiple births. It should be treated in a multi-disciplinary approach with the combination of a pediatrician, neurologist, or orthopaedic surgeon & physiotherapist. Aim of the study: The aim of the study was to assess the outcome of single-stage multilevel surgery of spastic Cerebral Palsy (CP). Methods: This prospective Experimental Study (quasi experimental Study) was conducted from July 2012 to June 2014 at the Department of Orthopaedics, Dhaka Medical College Hospital, and different clinics in Dhaka city. Twenty patients with diplegic and hemiplegic spastic cerebral palsy were recorded. Preoperative and post operative GMFCS and gait pattern of each patient were recorded for evaluation of results. Among them 12-patient were diplegic and 08 patients were hemiplegic. Data was collected and recorded sequentially and analyzed by SPSS computer software program, version 20 and MS-Excel 2016. Results: Mean follow up time was 13 months. There were 15 (75%) excellent, 5 (25%) good results assessed clinically by comparing preoperative and post operative gait pattern and GMFCS scoring system. Complications including superficial skin infection in 4 cases. There was no recurrence. Conclusion: Single-stage multilevel soft-tissue surgery in the lower limb(s) in children with spastic CP yields good results for locomotion and good trunk control.