Long-term effects of spasticity treatment, including selective dorsal rhizotomy, for individuals with cerebral palsy

Selective Dorsal Rhizotomy Outcomes Research Team

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

AIM: To understand the long-term effects of comprehensive spasticity treatment, including selective dorsal rhizotomy (SDR), on individuals with spastic cerebral palsy.

METHOD: This was a pre-registered, multicenter, retrospectively matched cohort study. Children were matched on age range and spasticity at baseline. Children at one center underwent spasticity treatment including SDR (Yes-SDR, n=35) and antispastic injections. Children at two other centers had no SDR (No-SDR, n=40 total) and limited antispastic injections. All underwent subsequent orthopedic treatment. Participants returned for comprehensive long-term assessment (age ≥21y, follow-up ≥10y). Assessment included spasticity, contracture, bony alignment, strength, gait, walking energy, function, pain, stiffness, participation, and quality of life.

RESULTS: Spasticity was effectively reduced at long-term assessment in the Yes-SDR group and was unchanged in the No-SDR group. There were no meaningful differences between the groups in any measure except the Gait Deviation Index (Yes-SDR + 11 vs No-SDR + 5) and walking speed (Yes-SDR unchanged, No-SDR declined 25%). The Yes-SDR group underwent more subsequent orthopedic surgery (11.9 vs 9.7 per individual) and antispastic injections to the lower limbs (14.4 vs <3, by design).

INTERPRETATION: Untreated spasticity does not cause meaningful impairments in young adulthood at the level of pathophysiology, function, or quality of life.

Original languageEnglish (US)
Pages (from-to)561-568
Number of pages8
JournalDevelopmental Medicine and Child Neurology
Volume64
Issue number5
DOIs
StatePublished - May 2022

Bibliographical note

Publisher Copyright:
© 2021 Mac Keith Press.

Keywords

  • Adult
  • Cerebral Palsy/complications
  • Child
  • Cohort Studies
  • Humans
  • Muscle Spasticity/drug therapy
  • Quality of Life
  • Retrospective Studies
  • Rhizotomy/adverse effects
  • Treatment Outcome
  • Young Adult

PubMed: MeSH publication types

  • Journal Article
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

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