Long Term Functional Outcomes After SDR

Long term follow up data was analyzed pre-operatively, 1 year, 5 years, 10 years and 15 years from 102 patients with spastic cerebral palsy who had a selective dorsal rhizotomy (SDR).  The results indicated the following:

• statistically significant improvements seen in spasticity, Gross Motor Function Measure (GMFM), activities of daily living up to 10 and 15 years after SDR (ie, though adolescence and into early adulthood).
• when severity of the Gross Motor Function Classification System (GMFCS) was taken into account the researchers found longlasting improvements through adolescence, which were not seen in the previously reported natural history curves for patients who did not have SDR
• patients had half as many orthopedic procedures as reported in the literature for patients without SDR

Reference: Dudley RW, Parolin M, Gagnon B, Saluja RS, Yap R, Monpetit K, Ruck J, Poulin C, Cantin MA, Benaroch T, Farmer JP. Beneficial Functional Outcomes of Selective Dorsal Rhizotomy (SDR) Are Long Lasting and Alter the Natural History of Motor Development in Spastic Cerebral Palsy. Neurosurgery. 2012 Aug;71(2):E564-5.  

Upper Extremity Function and Spastic Cerebral Palsy

A recent study looked at upper limb deformities, upper limb function and its relation to gross motor function. The researchers analyzed data from 234 children with spastic cerebral palsy. The results indicated the following:

• 70.5% had a limitation in forearm supination

• 62.8% had problems with wrist and finger extension in at least one limb

• Thumb-in-palm deformity of at least one hand was found in 47.0% of patients

• Swan neck deformity was the most common finger deformity

• "the degree of upper limb deformity was significantly related to the GMFCS level in children with bilateral CP, but not in children with unilateral CP"

• limitation in forearm supination was the most common in children with spastic cerebral palsy

Reference: Park ES, Sim EG, Rha DW. Effect of upper limb deformities on gross motor and upper limb functions in children with spastic cerebral palsy. Res Dev Disabil. 2011 Aug 5. [Epub ahead of print]

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