Incidence of spinal abnormalities in patients with spastic diplegia 17 to 26 years after selective dorsal rhizotomy. 2009

Nelleke G Langerak, and Christopher L Vaughan, and Edward B Hoffman, and Anthony A Figaji, and A Graham Fieggen, and Jonathan C Peter
MRC/UCT Medical Imaging Research Unit, Department of Human Biology, University of Cape Town, Observatory, Cape Town, Western Cape 7925, South Africa. Nelleke.Langerak@uct.ac.za

BACKGROUND The aim of this study was to evaluate the mechanical status of the spine in patients with spastic diplegia 17-26 years after selective dorsal rhizotomy (SDR). METHODS We compared original radiographic reports from our earlier short-term follow-up study with current X-rays. In addition, we obtained magnetic resonance images (MRI) of the spine and additional information regarding back pain and clinical assessments. RESULTS Thirty patients (17 males and 13 females; median age 26.8 years) participated in the current study, with median follow-up times of 4.0 and 21.4 years. Comparison of the X-ray results showed respectively: scoliosis 0% and 57%; kyphosis 0% and 7%; lordosis 21% and 40%; spondylolysis 18% and 37%; and spondylolisthesis grade I occurred in one patient. The only statistically significant difference was found for scoliosis (p < 0.01). The majority had Cobb angles <30 degrees with only two patients with curves of 35 degrees. MRI scans showed spinal stenosis in 27%, black discs in 10%, and disc protrusion in 3%. Daily back pain was reported in 17%, while 23% reported "moderate disability" as a result of back and leg pain. No patient to date has required any surgical intervention on the spine. CONCLUSIONS Except for spondylolisthesis, spinal deformities did appear to progress with time. However, this increase was not marked, and the development of relatively mild scoliosis was the only statistically significant increase. This group of patients requires continued follow-up. Further studies are required to ascertain the natural history of spinal deformity in adults with spastic diplegia who have not had SDR.

UI MeSH Term Description Entries
D008159 Lumbar Vertebrae VERTEBRAE in the region of the lower BACK below the THORACIC VERTEBRAE and above the SACRAL VERTEBRAE. Vertebrae, Lumbar
D008297 Male Males
D011788 Quality of Life A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral, social environment as well as health and disease. HRQOL,Health-Related Quality Of Life,Life Quality,Health Related Quality Of Life
D011795 Surveys and Questionnaires Collections of data obtained from voluntary subjects. The information usually takes the form of answers to questions, or suggestions. Community Survey,Nonrespondent,Questionnaire,Questionnaires,Respondent,Survey,Survey Method,Survey Methods,Surveys,Baseline Survey,Community Surveys,Methodology, Survey,Nonrespondents,Questionnaire Design,Randomized Response Technique,Repeated Rounds of Survey,Respondents,Survey Methodology,Baseline Surveys,Design, Questionnaire,Designs, Questionnaire,Methods, Survey,Questionnaire Designs,Questionnaires and Surveys,Randomized Response Techniques,Response Technique, Randomized,Response Techniques, Randomized,Survey, Baseline,Survey, Community,Surveys, Baseline,Surveys, Community,Techniques, Randomized Response
D002547 Cerebral Palsy A heterogeneous group of nonprogressive motor disorders caused by chronic brain injuries that originate in the prenatal period, perinatal period, or first few years of life. The four major subtypes are spastic, athetoid, ataxic, and mixed cerebral palsy, with spastic forms being the most common. The motor disorder may range from difficulties with fine motor control to severe spasticity (see MUSCLE SPASTICITY) in all limbs. Spastic diplegia (Little disease) is the most common subtype, and is characterized by spasticity that is more prominent in the legs than in the arms. Pathologically, this condition may be associated with LEUKOMALACIA, PERIVENTRICULAR. (From Dev Med Child Neurol 1998 Aug;40(8):520-7) Diplegic Infantile Cerebral Palsy,Little Disease,Monoplegic Cerebral Palsy,Quadriplegic Infantile Cerebral Palsy,Spastic Diplegia,CP (Cerebral Palsy),Cerebral Palsy, Athetoid,Cerebral Palsy, Atonic,Cerebral Palsy, Congenital,Cerebral Palsy, Diplegic, Infantile,Cerebral Palsy, Dyskinetic,Cerebral Palsy, Dystonic-Rigid,Cerebral Palsy, Hypotonic,Cerebral Palsy, Mixed,Cerebral Palsy, Monoplegic, Infantile,Cerebral Palsy, Quadriplegic, Infantile,Cerebral Palsy, Rolandic Type,Cerebral Palsy, Spastic,Congenital Cerebral Palsy,Diplegia, Spastic,Infantile Cerebral Palsy, Diplegic,Infantile Cerebral Palsy, Monoplegic,Infantile Cerebral Palsy, Quadriplegic,Little's Disease,Monoplegic Infantile Cerebral Palsy,Rolandic Type Cerebral Palsy,Athetoid Cerebral Palsy,Atonic Cerebral Palsy,Cerebral Palsies, Athetoid,Cerebral Palsies, Dyskinetic,Cerebral Palsies, Dystonic-Rigid,Cerebral Palsies, Monoplegic,Cerebral Palsy, Dystonic Rigid,Cerebral Palsy, Monoplegic,Diplegias, Spastic,Dyskinetic Cerebral Palsy,Dystonic-Rigid Cerebral Palsies,Dystonic-Rigid Cerebral Palsy,Hypotonic Cerebral Palsies,Hypotonic Cerebral Palsy,Mixed Cerebral Palsies,Mixed Cerebral Palsy,Monoplegic Cerebral Palsies,Spastic Cerebral Palsies,Spastic Cerebral Palsy,Spastic Diplegias
D005260 Female Females
D005500 Follow-Up Studies Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease. Followup Studies,Follow Up Studies,Follow-Up Study,Followup Study,Studies, Follow-Up,Studies, Followup,Study, Follow-Up,Study, Followup
D006304 Health Status The level of health of the individual, group, or population as subjectively assessed by the individual or by more objective measures. General Health,General Health Level,General Health Status,Level of Health,Overall Health,Overall Health Status,General Health Levels,Health Level,Health Level, General,Health Levels,Health Status, General,Health Status, Overall,Health, General,Health, Overall,Level, General Health,Levels, General Health,Status, General Health,Status, Health,Status, Overall Health
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults

Related Publications

Nelleke G Langerak, and Christopher L Vaughan, and Edward B Hoffman, and Anthony A Figaji, and A Graham Fieggen, and Jonathan C Peter
January 1996, Journal of pediatric orthopedics,
Nelleke G Langerak, and Christopher L Vaughan, and Edward B Hoffman, and Anthony A Figaji, and A Graham Fieggen, and Jonathan C Peter
January 2017, Asian journal of neurosurgery,
Nelleke G Langerak, and Christopher L Vaughan, and Edward B Hoffman, and Anthony A Figaji, and A Graham Fieggen, and Jonathan C Peter
April 2002, Archives of physical medicine and rehabilitation,
Nelleke G Langerak, and Christopher L Vaughan, and Edward B Hoffman, and Anthony A Figaji, and A Graham Fieggen, and Jonathan C Peter
July 2019, Cureus,
Nelleke G Langerak, and Christopher L Vaughan, and Edward B Hoffman, and Anthony A Figaji, and A Graham Fieggen, and Jonathan C Peter
October 2020, Journal of neurosurgery. Spine,
Nelleke G Langerak, and Christopher L Vaughan, and Edward B Hoffman, and Anthony A Figaji, and A Graham Fieggen, and Jonathan C Peter
September 1997, Archives of physical medicine and rehabilitation,
Nelleke G Langerak, and Christopher L Vaughan, and Edward B Hoffman, and Anthony A Figaji, and A Graham Fieggen, and Jonathan C Peter
January 2015, Surgical neurology international,
Nelleke G Langerak, and Christopher L Vaughan, and Edward B Hoffman, and Anthony A Figaji, and A Graham Fieggen, and Jonathan C Peter
November 1996, Developmental medicine and child neurology,
Nelleke G Langerak, and Christopher L Vaughan, and Edward B Hoffman, and Anthony A Figaji, and A Graham Fieggen, and Jonathan C Peter
May 2005, Journal of neurosurgery,
Nelleke G Langerak, and Christopher L Vaughan, and Edward B Hoffman, and Anthony A Figaji, and A Graham Fieggen, and Jonathan C Peter
July 2005, Journal of neurosurgery,
Copied contents to your clipboard!