TITLE

Lumbosacral vertically limited selective posterior rhizotomy in children with spastic diplegic cerebral palsy

AUTHOR(S)
Bhattacharjee, Suchanda; Purohit, A. K.; Sonylal, E.
PUB. DATE
July 2007
SOURCE
Journal of Pediatric Neurosciences;Jul-Dec2007, Vol. 2 Issue 2, p104
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
OBJECTIVE: This study aims at reduction of harmful resistant spasticity in the lower limbs to produce helpful muscular tone in children with cerebral palsy with minimum necessary ablation in the sensory path of monosynaptic reflex pathway acting at cauda equina. We present here our experience in the management of children harbouring spastic diplegic variant of cerebral palsy. MATERIALS AND METHODS:Vertically limited selective posterior rhizotomy[VL-SPR] was performed in 50 children in the age group of 5 to 20 years. Children who fitted the inclusion criteria were those who were unable to attain or maintain various postures or difficulty to maintain voluntary movements. Children who have developed or having the potential for developing contractures or children with disabling pain or those who did not respond to any other form of therapy. Vertically in the spine only L4 and L5 partial laminectomy is performed and then L5, S1 and if required S2 SPR is performed. Post operatively patients were followed at 3, 6 and 12 months and spasticity as used by modified Ashworth Scale and functional outcome by WeeFIM scoring system. RESULT: In the first twenty cases analysed by Wilcoxon rank-sum test there was a significant improvement of 0.72 (2.11-1.38) at hip adductor, 1.13 (3.16-2.03) at knee flexors and 2.06 (2.6,1-0.55) at ankle plantar flexors with P values <0.008, <0.00008, <0.0000004 respectively post operatively by Modified Ashworth Scale. The WeeFIM score analysis showed an improvement of 13.78 (99.11-85.33). In the other 30 cases the improvement trend was similar to the first 20 cases. Conclusion: From this study we conclude that lumbosacral VL-SPR in children with spastic diplegic variant of cerebral palsy is an economic way of providing a gratifying level of improvement in spasticity and making further management of this developmental disease easier in the little ones.
ACCESSION #
27450653

 

Related Articles

  • Oral Baclofen and Clonidine for Treatment of Spasticity in Children. Lubsch, Lisa; Habersang, Rolf; Haase, Mark; Luedtke, Sherry // Journal of Child Neurology;Dec2006, Vol. 21 Issue 12, p1090 

    Few data exist in the literature to support the use of high dosages of oral baclofen and clonidine that are frequently required to treat children with spasticity. This study was a retrospective chart review of baclofen and clonidine dosages used in children diagnosed with cerebral palsy or...

  • Disappearance of Spasticity After Selective Dorsal Rhizotomy Does Not Prevent Muscle Shortening in Children With Cerebral Palsy: A Case Report. Spijker, Margje; Strijers, Rob L. M.; van Ouwerkerk, Willem J. R.; Becher, Jules G. // Journal of Child Neurology;May2009, Vol. 24 Issue 5, p625 

    Selective dorsal rhizotomy is an effective treatment for spasticity in children with cerebral palsy who have a spastic motor disorder. It is hypothesized that muscle shortening is related to spasticity; the lack of stretch of a muscle is thought to be the cause of muscle shortening. If this is...

  • A Pediatric Revolution At Home. Arango, Polly // Health Affairs;Sep/Oct2004, Vol. 23 Issue 5, p237 

    Relates the author's experience of raising a son with cerebral palsy. Difficulties experienced by the author as a mother; Change of diagnosis from cerebral palsy to a progressive neurological disorder of unknown origin; Medical assistance provided to her son; Onset of seizure disorder and loss...

  • Muscle Performance of Children With Spastic Cerebral Palsy. Parker, D.; Carriere, L.; Hebestreit, H.; Salsberg, A.; Bar-Or, O. // Adapted Physical Activity Quarterly;Oct1993, Vol. 10 Issue 4, p395 

    This article presents a study examining the effects of spastic cerebral palsy on muscle performance in children. Its aim was to develop a better understanding of physiological fitness within these children. A group of children with spastic cerebral palsy were examined, with researchers focusing...

  • Cerebral Palsy: An Overview. Krigger, Karen W. // American Family Physician;1/1/2006, Vol. 73 Issue 1, p91 

    The presentation of cerebral palsy can be global mental and physical dysfunction or isolated disturbances in gait, cognition, growth, or sensation. It is the most common childhood physical disability and affects 2 to 2.5 children per 1,000 born in the United States. The differential diagnosis of...

  • Am. J. Diseases of Children. Dolphin, Jane E. // Exceptional Children;Jan1955, Vol. 21 Issue 4, p156 

    The article provides an overview of the report "Case-Finding of Handicapped Children, With Special Reference to Cerebral Palsy," by Helen M. Wallace published in the September 1954 issue of the "American Journal for Diseases of Children."

  • Selective dorsal rhizotomy. Abbott, Rick // Exceptional Parent;Sep97, Vol. 27 Issue 9, p81 

    Focuses on the treatment of selective dorsal rhizotomy (SDR, also called functional dorsal rhizotomy) in children with cerebral palsy used to treat spasticity. What SDR is used for; Background information on the procedure; Evaluation of SDR; Identification of the categories of candidates;...

  • New procedure helps speed recovery.  // USA Today Magazine;Feb95, Vol. 123 Issue 2597, p5 

    Reports on the effectiveness of selective dorsal rhizotomy in reducing spasticity in children with cerebral palsy. Advantages and disadvantages; Steps involved in selective dorsal rhizotomy.

  • Chapter 2: Types of Cerebral Palsy. Peacock, Judith // Cerebral Palsy (Capstone Press);2000, p12 

    This chapter describes the types of cerebral palsy. There are several different forms of cerebral palsy, which are classified by how the movement of the body is affected and which part of the body is most affected. Types of cerebral palsy that influences movement are spastic cerebral palsy,...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics