SPINAL DEFORMITIES AFTER SELECTIVE DORSAL RHIZOTOMY

Autor: PATRICIO PABLO MANZONE, MARÍA SELVA VALLEJOS ARCE, EDITH ORSINI, MARIANO DORTIGNAC, EDUARDO MARIÑO AVALOS, MARIA LORENA CARDOZO IÑIGUEZ, JOSÉ GEMETRO
Jazyk: English<br />Spanish; Castilian<br />Portuguese
Předmět:
Zdroj: Coluna/Columna, Vol 15, Iss 3, Pp 186-190
Druh dokumentu: article
ISSN: 2177-014X
1808-1851
DOI: 10.1590/S1808-185120161503149860
Popis: ABSTRACT Objective: Selective dorsal rhizotomy (SDR) used for spasticity treatment could worsen or develop spinal deformities. Our goal is to describe spinal deformities seen in patients with cerebral palsy (CP) after being treated by SDR. Methods: Retrospective study of patients operated on (SDR) between January/1999 and June/2012. Inclusion criteria: spinal Rx before SDR surgery, spinography, and assessment at follow-up. We evaluated several factors emphasizing level and type of SDR approach, spinal deformity and its treatment, final Risser, and follow-up duration. Results: We found 7 patients (6 males): mean age at SDR 7.56 years (4.08-11.16). Mean follow-up: 6.64 years (2.16-13), final age: 14.32 years (7.5-19). No patient had previous deformity. GMFCS: 2 patients level IV, 2 level III, 3 level II. Initial walking status: 2 community walkers, 2 household walkers, 2 functional walkers, 1 not ambulant, at the follow-up, 3 patients improved, and 4 kept their status. We found 4 TL/L laminotomies, 2 L/LS laminectomies, and 1 thoracic laminectomy. Six spinal deformities were observed: 2 sagittal, 3 mixed, and 1 scoliosis. There was no association among the type of deformity, final gait status, topographic type, GMFCS, age, or SDR approach. Three patients had surgery indication for spinal deformity at skeletal maturity, while those patients with smaller deformities were still immature (Risser 0 to 2/3) although with progressive curves. Conclusions: After SDR, patients should be periodically evaluated until they reach Risser 5. The development of a deformity does not compromise functional results but adds morbidity because it may require surgical treatment.
Databáze: Directory of Open Access Journals
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