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196375

SURGICAL MANAGEMENT OF SPASTIC DIPARESIS IN SELECTED CASES OF CEREBRAL PALSY BY "SELECTIVE DORSAL RHIZOTOMY" OPERATION

Article

Last updated: 04 Jan 2025

Subjects

-

Tags

Surgery

Abstract

Background: Spasticity affects a large number of children, mainly in the setting of cerebral palsy, however, only a few paediatric neurosurgeons deal with this problem. This is mainly due to the fact that until 1979, when Fasano has published the first series of selective dorsal rhizotomy (SDR), neurosurgeons were able to provide such children only a modest help. Objectives: This work aims to study the effect of performing selective dorsal rhizotomy operation on patients suffering from spastic diparesis due to cerebral palsy, and the aim of surgery is to relieve the present spasticity, which is predominantly seen in the lower limbs, and to improve motor function. Patients and methods: This study was done on 30 patients with ages (4-12) years old, with mean age 8 years old, included patients from both sexes (16 males, 14 females), on Al-Azhar University Hospital and Dar El-shefa Hospital, in the period from January 2019 to August 2020. Results: In our study, we achieved significant results in our patients with sectioning 30-60% of rootlets, with preservation of motor power and no sensory loss. According to our results, an important factor that may improve outcome and prognosis of patients is the pre-operative mental state, as patients with acceptable mental ability has the potential to participate in more active physiotherapy programs that improve outcome greatly. However, even with decreased mentality there is post-operative decrease in muscle tone and reflexes, which may aid in making patient's decubitus less prone to pressure sores, and make the patient easier to handle, so, the proper care can be achieved. Also according to our study, the higher the grade of Aschworth's score is a good prognostic factor of achieving faster improvement of spasticity and gait. Conclusion: selective dorsal rhizotomy is not a cure for cerebral palsy. The procedure offers spastic CP children improved motor capabilities and increased levels of functioning. Achieving maximal benefits depends on how much and which of the posterior rootlets are cut.

DOI

10.21608/amj.2021.196375

Keywords

Surgical Management Spastic Diparesis, Cerebral palsy, Selective Dorsal Rhizotomy Operation

Authors

First Name

Ahmed

Last Name

Nasser Abdul-Hamid Al-Sayed

MiddleName

-

Affiliation

Department of Neurosurgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

Email

ahmedalsayed8085@gmail.com

City

-

Orcid

-

First Name

Ma'moun

Last Name

Abo-Shousha

MiddleName

-

Affiliation

Department of Neurosurgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

Email

-

City

-

Orcid

-

First Name

Mohammed

Last Name

Ahmed El-Labbad

MiddleName

-

Affiliation

Department of Neurosurgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

Email

-

City

-

Orcid

-

First Name

Alaa

Last Name

Rashad Ibrahim

MiddleName

-

Affiliation

Department of Neurosurgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

Email

-

City

-

Orcid

-

Volume

50

Article Issue

4

Related Issue

27826

Issue Date

2021-10-01

Receive Date

2021-09-27

Publish Date

2021-10-01

Page Start

2,363

Page End

2,378

Print ISSN

1110-0400

Link

https://amj.journals.ekb.eg/article_196375.html

Detail API

https://amj.journals.ekb.eg/service?article_code=196375

Order

2

Type

Original Article

Type Code

941

Publication Type

Journal

Publication Title

Al-Azhar Medical Journal

Publication Link

https://amj.journals.ekb.eg/

MainTitle

SURGICAL MANAGEMENT OF SPASTIC DIPARESIS IN SELECTED CASES OF CEREBRAL PALSY BY "SELECTIVE DORSAL RHIZOTOMY" OPERATION

Details

Type

Article

Created At

22 Jan 2023