Long-term results of surgical treatment of patients suffering from cerebral palsy.

OBJECTIVES: Cerebral palsy is defined as a syndrome subsequent to attack of developing brain and characterized by loss of normal controle of motor function. Orthopaedic surgeon have to select patients who will have benefit from surgery, and to perform it by that way, that will improve the motorical ability of the child.

BACKGROUND: The operations performed in the past at one level were replaced by modern ,,multilevel approach" in case of need. The aim of this study was the analysis of the long term results of that new surgical approaches.

METHODS: Evaluated were 275 patients diagnosed as having spastic or mixed form of cerebral palsy (CP). The average age at the time of surgery was 7.8 years (3 to 16 years). Altogether in 20 years 941 surgical procedures, mainly on the lower limbs were performed.

RESULTS: Overall 9 % excellent, 53 % very good, 26 % good and 12 % bad results were achieved. Using single level unilateral operations 7 % excellent, 46 % very good, 30 % good and 17 % fair results were achieved. Comparing to this, using the modern methods, 11 % excelent, 57 % very good, 23 % good and 9 % of bad results were achieved.

CONCLUSION: Authors believe, that the broad and early multilevel surgery, acomplished with proper physiotherapy is an important fact for improvement of outcome in treatment of children suffering from cerebral palsy (Tab. 2, Ref 6).