Preoperative MRI findings and functional outcome after selective dorsal rhizotomy in children with bilateral spasticity

Grunt, Sebastian; Becher, Jules G; van Schie, Petra; van Ouwerkerk, Willem J R; Ahmadi, Mazarin; Vermeulen, R Jeroen (2010). Preoperative MRI findings and functional outcome after selective dorsal rhizotomy in children with bilateral spasticity. Child's nervous system, 26(2), pp. 191-8. Heidelberg: Springer 10.1007/s00381-009-0999-z

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PURPOSE: To identify MRI characteristics that may predict the functional effect of selective dorsal rhizotomy (SDR) in children with bilateral spastic paresis. METHODS: We performed SDR in a group of 36 patients. The gross motor functioning measure-66 (GMFM-66) was applied before and after SDR. Available cerebral MRIs were retrospectively classified into three diagnostic groups: periventricular leucomalacia (PVL; n = 10), hydrocephalus (n = 2), and normal (n = 6). In patients with PVL, we scored the severity of the MR abnormalities. We compared the changes in the GMFM-66 after SDR in the diagnostic groups. In patients with PVL, we correlated the severity of the MR abnormalities with the changes in the GMFM-66. RESULTS: The mean follow-up period was 5 years and 4 months (range, 1 year and 1 month to 9 years). The best improvement in gross motor function was observed in patients with normal MRI, and the slightest improvement was observed in patients with hydrocephalus. The severity of the PVL did correlate with the GMFM-66 score before SDR but not with the functional effect of SDR. CONCLUSION: We conclude that with respect to gross motor skills, the improvements after SDR are good in patients with no MRI abnormalities. In the patients with hydrocephalus, the improvements after SDR were insignificant. In patients with PVL, the improvements were intermediate and did not correlate with the degree of PVL.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine

UniBE Contributor:

Grunt, Sebastian

ISSN:

0256-7040

Publisher:

Springer

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 14:07

Last Modified:

04 May 2014 23:04

Publisher DOI:

10.1007/s00381-009-0999-z

PubMed ID:

19823844

Web of Science ID:

000273241700008

URI:

https://boris.unibe.ch/id/eprint/168 (FactScience: 196599)

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