Combined Anterior and Posterior Lumbar Rhizotomy for Treatment of Mixed Dystonia and Spasticity in Children With Cerebral Palsy

Combined Anterior and Posterior Lumbar Rhizotomy for Treatment of Mixed Dystonia and Spasticity in Children With Cerebral Palsy

Abstract BACKGROUND: Children with cerebral palsy (CP) can present with severe secondary dystonia with or without associated spasticity of their extremities. OBJECTIVE: To assess the outcomes of combined anterior and posterior lumbar rhizotomy for the treatment of mixed hypertonia in the lower extre...

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Bibliographic Details
Published in:Neurosurgery Vol. 79; no. 3; pp. 336 - 344
Main Authors: Abdel Ghany, Walid A., Nada, Mohamed, Mahran, Mahmoud A., Aboud, Ahmed, Mahran, Moustafa G., Nasef, Marwa A.A., Gaber, Mohamed, Sabry, Tamer, Ibrahim, Mohamed H., Taha, Mohamed H.
Format: Journal Article
Language:English
Published: United States Oxford University Press 01-09-2016
Copyright by the Congress of Neurological Surgeons
Wolters Kluwer Health, Inc
Neurosurgery
Subjects:
Activities of Daily Living
Adolescent
Cerebral palsy
Cerebral Palsy - complications
Cerebral Palsy - surgery
Child
Dystonia
Dystonic Disorders - etiology
Dystonic Disorders - surgery
Female
Humans
Male
Muscle Spasticity - etiology
Muscle Spasticity - surgery
Neurosurgery
Postoperative Period
Prospective Studies
Range of Motion, Articular - physiology
Research—Human—Clinical Trials
Rhizotomy - methods
Spasticity
Treatment Outcome
Cerebral palsy
Habilitation
Spasticity
Rhizotomy
Dystonia
Mixed hypertonia
Botulinum toxin
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Summary:Abstract BACKGROUND: Children with cerebral palsy (CP) can present with severe secondary dystonia with or without associated spasticity of their extremities. OBJECTIVE: To assess the outcomes of combined anterior and posterior lumbar rhizotomy for the treatment of mixed hypertonia in the lower extremities of children with CP. METHODS: Fifty children with CP were subjected to combined anterior and posterior lumbar rhizotomies in a prospective study. Clinical outcome measurements were recorded preoperatively and were evaluated at 2, 6, and 12 months postoperatively. The operative techniques were performed by laminotomy from L1-S1, and intraoperative monitoring was used in all cases. All patients underwent intensive postoperative physiotherapy programs. RESULTS: Changes in muscle tone, joint range of motion, and dystonia were significant (P =.000) at postoperative assessment visits. CONCLUSION: This study demonstrated the potential of combined anterior and posterior lumbar rhizotomies to improve activities of daily living in children with CP and with mixed spasticity and dystonia.
Bibliography:ObjectType-Article-2
SourceType-Scholarly Journals-1
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ISSN:0148-396X
1524-4040
DOI:10.1227/NEU.0000000000001271