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Dev Med Child Neurol. 2017 Oct;59(10):1089-1095. doi: 10.1111/dmcn.13481. Epub 2017 Jun 15.

Long-term impact of childhood selective dorsal rhizotomy on pain, fatigue, and function: a case-control study.

Author information

1
Department of Physical Medicine & Rehabilitation, University of Michigan Medical School, Ann Arbor, MI, USA.

Abstract

AIM:

Selective dorsal rhizotomy (SDR) is a surgical treatment for spasticity in children with cerebral palsy (CP). Studies suggest long-lasting effects of SDR on spasticity; long-term effects on symptoms and function are not clear. This study tested whether adults with CP (average 22y after SDR) report less pain, fatigue, and functional decline than a retrospectively assessed non-surgical comparison group.

METHOD:

This was a case-control study. Eighty-eight adults with CP (mean age 27y; SDR=38 male/female/missing=20/16/2; non-surgical [comparison]=50, male/female=19/31) recruited from a tertiary care center and the community completed a battery of self-reported outcome measures. Regression models were used to test whether SDR status predicted pain, fatigue, functional change, and hours of assistance (controlling for Gross Motor Function Classification System level).

RESULTS:

SDR status did not significantly predict pain interference (p=0.965), pain intensity (p=0.512), or fatigue (p=0.404). SDR related to lower decline in gross motor functioning (p=0.010) and approximately 6 fewer hours of daily assistance than for those in the comparison group (p=0.001).

INTERPRETATION:

Adults with CP who had SDR in childhood reported less gross motor decline and fewer daily assistance needs than non-surgically treated peers, suggesting the functional impact of SDR persists long after surgery.

PMID:
28617943
PMCID:
PMC5610610
DOI:
10.1111/dmcn.13481
[Indexed for MEDLINE]
Free PMC Article

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