keyword
https://read.qxmd.com/read/37877954/upper-extremity-spasticity-and-functionality-after-selective-dorsal-rhizotomy-for-cerebral-palsy-a-systematic-review
#21
JOURNAL ARTICLE
Lisanne Merckx, Fauve Poncelet, Hannah De Houwer, Armand Laumen, Leen Peeters, Bart Nuttin, Petra Pauwels, Anja Van Campenhout, Els Ortibus, Philippe De Vloo
OBJECTIVE: Lumbosacral selective dorsal rhizotomy is a neurosurgical treatment option to reduce spasticity in the lower extremities in children with cerebral palsy. Surprisingly, concomitant improvement of spasticity in the upper extremities and functionality of the hands has been sporadically reported postoperatively. In this systematic review, the authors aimed to quantify the postoperative improvement in upper-extremity spasticity and functionality, identify predictors, and discuss underlying mechanisms...
December 1, 2023: Journal of Neurosurgery. Pediatrics
https://read.qxmd.com/read/37801614/comparison-of-outcomes-following-surgical-intervention-and-inpatient-rehabilitation-stays-in-children-with-cerebral-palsy
#22
JOURNAL ARTICLE
Christian Niedzwecki, Amy Barbuto, Katy Mitchell, Steven Wirt, Michelle Seymour, Sruthi Thomas, Aloysia Schwabe
INTRODUCTION: Literature is limited on functional outcomes in children with cerebral palsy (CP) following surgical procedures and a subsequent inpatient rehabilitation unit (IRU) stay. OBJECTIVE: To compare functional outcomes and length of stay (LOS) in children with CP following a surgical procedure and IRU stay based on the surgical procedure performed, pattern of involvement, etiology, and Gross Motor Function Classification System (GMFCS) level. DESIGN: Retrospective cohort study...
October 6, 2023: PM & R: the Journal of Injury, Function, and Rehabilitation
https://read.qxmd.com/read/37783799/surgical-treatment-options-for-spasticity-in-children-and-adolescents-with-hereditary-spastic-paraplegia
#23
JOURNAL ARTICLE
Laura A van de Pol, Nina Burgert, Petra E M van Schie, K Mariam Slot, Alida A Gouw, Annemieke I Buizer
PURPOSE: To provide an overview of outcome and complications of selective dorsal rhizotomy (SDR) and intrathecal baclofen pump implantation (ITB) for spasticity treatment in children with hereditary spastic paraplegia (HSP). METHODS: Retrospective study including children with HSP and SDR or ITB. Gross motor function measure (GMFM-66) scores and level of spasticity were assessed. RESULTS: Ten patients were included (most had mutations in ATL1 (n = 4) or SPAST (n = 3) genes)...
October 3, 2023: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://read.qxmd.com/read/37676296/gabapentin-as-part-of-a-multimodal-pain-protocol-for-selective-dorsal-rhizotomy-does-not-impact-percentage-of-rootlets-transected
#24
JOURNAL ARTICLE
Mary E Lynch, David J Daniels, Joline E Brandenburg
PURPOSE: We aim to determine whether preoperatively initiated gabapentin for pain control impacts the percentage of rootlets cut during monitored, limited laminectomy selective dorsal rhizotomy (SDR) procedure. METHODS: This retrospective cohort study includes participants with cerebral palsy who had SDR for treatment of spasticity between 2010 and 2019 at a single-institution tertiary care center. One-level laminectomy SDR aimed to evaluate the cauda equina roots from levels L2-S1 with EMG monitoring...
September 7, 2023: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://read.qxmd.com/read/37620087/treatment-of-spasticity
#25
REVIEW
Jonathan Marsden, Valerie Stevenson, Louise Jarrett
Spasticity is characterized by an enhanced size and reduced threshold for activation of stretch reflexes and is associated with "positive signs" such as clonus and spasms, as well as "negative features" such as paresis and a loss of automatic postural responses. Spasticity develops over time after a lesion and can be associated with reduced speed of movement, cocontraction, abnormal synergies, and pain. Spasticity is caused by a combination of damage to descending tracts, reductions in inhibitory activity within spinal cord circuits, and adaptive changes within motoneurons...
2023: Handbook of Clinical Neurology
https://read.qxmd.com/read/37572544/the-long-term-effects-of-aggressive-spasticity-reducing-treatment-including-selective-dorsal-rhizotomy-on-joint-kinematic-outcomes-of-persons-with-cerebral-palsy
#26
JOURNAL ARTICLE
Mark L McMulkin, Bruce A MacWilliams, Elizabeth A Nelson, Meghan E Munger, Brian Po-Jung Chen, Tom F Novacheck, Kristen L Carroll, Alan K Stotts, Lisa H Carter, Shelley L Mader, Brianna Hayes, Glen O Baird, Michael H Schwartz
BACKGROUND: Selective dorsal rhizotomy (SDR) creates a large and permanent reduction of spasticity for children with cerebral palsy (CP). Previous SDR outcomes studies have generally lacked appropriate control groups, had limited sample sizes, or reported short-term follow-up, limiting evidence for improvement in long-term gait function. RESEARCH QUESTION: Does aggressive spasticity management for individuals with CP improve long-term gait kinematics (discrete joint kinematics) compared to a control group of individuals with CP with minimal spasticity management? METHODS: This study was a secondary analysis - focused on joint-level kinematics - of a previous study evaluating the long-term outcomes of SDR...
August 2, 2023: Gait & Posture
https://read.qxmd.com/read/37556940/selective-dorsal-rhizotomy-patient-demographics-and-postoperative-physical-therapy
#27
JOURNAL ARTICLE
Kristen Blatt, Jessica Lewis, Rachel Bican, Jeffrey Leonard
BACKGROUND: Selective dorsal rhizotomy (SDR) is a surgical procedure that permanently alters lower extremity spasticity, common in children with spastic cerebral palsy (CP). Intensive postoperative physical therapy (PT) is recommended following SDR. The first purpose of this study is to describe and compare patient demographics between children who received SDR and the population of children with CP at one institution. The second purpose of this study is to compare the completed dose of postoperative PT with the clinically recommended dose for a subset of ambulatory children who underwent SDR...
October 2023: Pediatric Neurology
https://read.qxmd.com/read/37493022/the-effect-of-selective-dorsal-rhizotomy-on-hip-displacement-in-children-with-cerebral-palsy-a-long-term-follow-up-study
#28
JOURNAL ARTICLE
Stacey D Miller, Maria Juricic, Jeffrey N Bone, Paul Steinbok, Kishore Mulpuri
BACKGROUND: Hip displacement is common in children with cerebral palsy (CP). Spasticity in the hip adductor muscles, hip flexors, and medial hamstrings has been identified as a possible cause of progressive hip displacement. Selective dorsal rhizotomy (SDR) aims to reduce lower extremity spasticity in children with CP. Here, we investigate the influence of SDR on hip displacement in children with CP at long-term follow-up, a minimum of 5 years post-SDR. METHODS: A retrospective review of children undergoing SDR at a Canadian pediatric hospital was completed...
July 24, 2023: Journal of Pediatric Orthopedics
https://read.qxmd.com/read/37439914/selective-dorsal-rhizotomy-in-non-ambulant-children-with-cerebral-palsy-a-multi-center-prospective-study
#29
JOURNAL ARTICLE
Conor S Gillespie, Benjamin J Hall, Alan M George, Dawn Hennigan, Christine Sneade, Stephanie Cawker, Adikarige Haritha Dulanka Silva, Michael Vloeberghs, Kristian Aquilina, Benedetta Pettorini
PURPOSE: Assess the effects of selective dorsal rhizotomy (SDR) on motor function and quality of life in children with a Gross Motor Function Classification System (GMFCS) level of IV or V (non-ambulatory). METHODS: This is a prospective, observational study in three tertiary neurosurgery units in England, UK, performing SDR on children aged 3-18 with spastic diplegic cerebral palsy, and a GMFCS level of IV or V, between 2012 and 2019. The primary outcome measure was the change in the 66-item Gross Motor Function Measure (GMFM-66) from baseline to 24 months after SDR, using a linear mixed effects model...
July 13, 2023: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://read.qxmd.com/read/37410128/spasticity-and-movement-disorders-in-cerebral-palsy
#30
REVIEW
A Leland Albright
PURPOSE: To review the neurosurgical treatments of children with movement disorders associated with cerebral palsy (CP) during the previous decades, up to the present day. METHODS: An extensive literature review was undertaken to identify important publications about this subject. My experience treating children with these disorders over the past three decades was included in the individual sections. RESULTS: Peripheral neurotomies have been developed for children with focal spasticity...
October 2023: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://read.qxmd.com/read/37325833/-methods-and-results-of-neurosurgical-treatment-of-cerebral-palsy
#31
JOURNAL ARTICLE
A V Dekopov, A A Tomsky, E D Isagulyan
UNLABELLED: Treatment of spastic syndrome and muscular dystonia in patients with cerebral palsy is a complex clinical problem. Effectiveness of conservative treatment is not high enough. Modern neurosurgical techniques for spastic syndrome and dystonia are divided into destructive interventions and surgical neuromodulation. Their effectiveness is different and depends on the form of disease, severity of motor disorders and age of patients. OBJECTIVE: To evaluate the effectiveness of various methods of neurosurgical treatment of spasticity and muscular dystonia in patients with cerebral palsy...
2023: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://read.qxmd.com/read/37274819/quantitative-identification-of-ventral-dorsal-nerves-through-intraoperative-neurophysiological-monitoring-by-supervised-machine-learning
#32
JOURNAL ARTICLE
Wenbin Jiang, Qijia Zhan, Junlu Wang, Min Wei, Sen Li, Rong Mei, Bo Xiao
OBJECTIVE: This study aimed to investigate the electro-neurophysiological characteristics of the ventral and dorsal nerves at the L2 segment in a quantitative manner. METHODS: Medical records of consecutive patients who underwent single-level approach selective dorsal rhizotomy (SDR) from June 2019 to January 2022 were retrospectively reviewed. Intraoperative electro-neurophysiological data were analyzed. RESULTS: A total of 74 males and 27 females were included in the current study with a mean age of 6...
2023: Frontiers in Pediatrics
https://read.qxmd.com/read/37260383/identification-of-risk-factors-for-reconstructive-hip-surgery-after-intrathecal-baclofen-therapy-in-children-with-cerebral-palsy
#33
JOURNAL ARTICLE
Ali Asma, Jason J Howard, Armağan Can Ulusaloglu, Kenneth J Rogers, Freeman Miller, M Wade Shrader
OBJECTIVE: This study aimed to determine the risk factors for reconstructive hip surgery after intrathecal baclofen pump application in children with cerebral palsy. METHODS: Inclusion criteria were children with hypertonic (spastic or mixed spastic/dystonic motor type) cerebral palsy, intrathecal baclofen implantation <8 years of age, no reconstructive osteotomies prior to or concomitant with intrathecal baclofen implantation and at least a 5-year follow-up...
May 2023: Acta Orthopaedica et Traumatologica Turcica
https://read.qxmd.com/read/37238390/enhancing-post-operative-recovery-in-spastic-diplegia-through-physical-therapy-rehabilitation-following-selective-dorsal-rhizotomy-a-case-report-and-thorough-literature-analysis
#34
Jawaria Shahid, Ayesha Kashif, Muhammad Kashif Shahid
Spasticity is a common issue among children, especially those with bilateral spastic cerebral palsy (CP). Selective dorsal rhizotomy (SDR) is a surgical procedure that is often used to decrease lower limb rigidity, alongside other treatment options such as intrathecal medication, peripheral nerve surgery, and deep brain stimulation (DBS). The objective of these therapies is to improve the standard of living for young individuals. This article intends to explain the motor deficits observed in spastic diplegia and a rehabilitation program using physical therapy after SDR...
May 6, 2023: Children
https://read.qxmd.com/read/37208393/unsupervised-machine-learning-effectively-clusters-pediatric-spastic-cerebral-palsy-patients-for-determination-of-optimal-responders-to-selective-dorsal-rhizotomy
#35
JOURNAL ARTICLE
Xiaobin Hou, Yanyun Yan, Qijia Zhan, Junlu Wang, Bo Xiao, Wenbin Jiang
Selective dorsal rhizotomy (SDR) can reduce the spasticity in patients with spastic cerebral palsy (SCP) and thus improve the motor function in these patients, but different levels of improvement in motor function were observed among patients after SDR. The aim of the present study was to subgroup patients and to predict the possible outcome of SDR based on the pre-operational parameters. A hundred and thirty-five pediatric patients diagnosed with SCP who underwent SDR from January 2015 to January 2021 were retrospectively reviewed...
May 19, 2023: Scientific Reports
https://read.qxmd.com/read/37125789/3d-printing-model-of-a-patient-s-specific-lumbar-vertebra
#36
JOURNAL ARTICLE
Huizhong Bai, Zhuoluo Zhou, Gang Liu, Shengyuan Jiang, Yaqi Zhang, Xinwei Zuo, Fangliang Xing, Lin Xu, Li Wang, Xiaohong Mu
Selective dorsal rhizotomy (SDR) is a difficult, risky, and sophisticated operation, in which a laminectomy should not only expose an adequate surgical field of view but also protect the patient's spinal nerves from injury. Digital models play an important role in the pre-and intra-operation of SDR, because they can not only make doctors more familiar with the anatomical structure of the surgical site, but also provide precise surgical navigation coordinates for the manipulator. This study aims to create a 3D digital model of a patient-specific lumbar vertebra that can be used for planning, surgical navigation, and training of the SDR operation...
April 14, 2023: Journal of Visualized Experiments: JoVE
https://read.qxmd.com/read/37121638/spasticity-interventions-decision-making-and-management
#37
REVIEW
Joline E Brandenburg, Amy E Rabatin, Sherilyn W Driscoll
Spasticity results from an abnormality of the central nervous system and is characterized by a velocity-dependent increase in muscle tone or stiffness. In children, it can cause functional impairments, delays in achieving developmental or motor milestones, participation restrictions, discomfort, and musculoskeletal differences. Unique to children is the ongoing process of a maturing central nervous system and body, which can create the appearance of worsening or changing spasticity. Treatment options include physical interventions such as stretching, serial casting, and bracing; oral and injectable medications; and neurosurgical procedures such as selective dorsal rhizotomy and intrathecal baclofen pump...
June 2023: Pediatric Clinics of North America
https://read.qxmd.com/read/37075708/patient-and-caregiver-reported-outcome-measures-after-single-level-selective-dorsal-rhizotomy-in-pediatric-and-young-adult-patients-with-spastic-cerebral-palsy
#38
JOURNAL ARTICLE
Abeelan Rasadurai, Nicole Alexandra Frank, Ladina Aurea Greuter, Maria Licci, Peter Weber, Stephanie Jünemann, Raphael Guzman, Jehuda Soleman
INTRODUCTION: The aim of this cohort study is to assess the outcome of single-level selective dorsal rhizotomy (SDR) in children and young adults with spastic cerebral palsy (CP) treated at our institution, focusing on patient-reported outcome measures (PROMs) and quality of life (QoL) of patients and their caregivers. METHODS: We included consecutive patients undergoing SDR from 2018 to 2020 at our institution. Subjective outcome was measured through PROMs, while functional outcome was measured through baseline characteristics, operative outcome, as well as short- and long-term follow-up...
April 19, 2023: Pediatric Neurosurgery
https://read.qxmd.com/read/37009349/selective-dorsal-rhizotomy-for-treatment-of-spasticity-after-hemispherectomy-in-children-a-case-report
#39
T S Park, Susan Joh, Matthew D Smyth, Nicole L Meyer, Deanna M Walter
Performing a hemispherotomy or hemispherectomy is known to treat medically intractable epilepsy successfully, yet contralateral hemiparesis and increased muscle tone follow the epilepsy surgery. Spasticity and coexisting dystonia presumably cause the increased muscle tone in the lower extremity on the opposite side of epilepsy surgery. However, the extent of the role of spasticity and dystonia in high muscle tone is unknown. A selective dorsal rhizotomy is performed to reduce spasticity. If a selective dorsal rhizotomy is performed in the affected patient and muscle tone is reduced, the high muscle tone is not due to dystonia...
March 2023: Curēus
https://read.qxmd.com/read/36897794/medial-gastrocnemius-muscle-properties-of-children-with-cerebral-palsy-after-different-tone-treatments-a-pilot-study
#40
JOURNAL ARTICLE
Christiana J Raymond-Pope, Daniel B Hoffman, Rachael M Bloxsom, Sarah M Greising, Tom F Novacheck, Elizabeth R Boyer
OBJECTIVE: Spasticity in children with cerebral palsy (CP) can be managed by a spectrum of approaches, from conservative therapy to temporary botulinum toxin A (BoNT-A) injections, to permanent transection of sensory nerves with a selective dorsal rhizotomy (SDR). This pilot study investigated whether these three tone management approaches are associated with histological and biochemical properties of the medial gastrocnemius. DESIGN: A convenience sample of children with CP undergoing gastrocnemius lengthening surgery were enrolled...
March 8, 2023: American Journal of Physical Medicine & Rehabilitation
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