Pre- and Postoperative Gait Analysis and Video for Selective Dorsal Rhizotomy in Spastic Diplegia: 2-Dimensional Operative Video. 2019

Jacob Archer, and Alan P Yaacoub, and Francisco Angulo-Parker, and Gloria Fritsch, and Shana Riner, and Ann Coon, and Sarah K Johnson, and Sarah Delima, and Andrew Jea, and Jeffrey S Raskin
Section of Pediatric Neurosurgery, Department of Neurological Surgery, Riley Hospital for Children, Indiana University School of Medicine, Goodman Campbell Brain and Spine, Indianapolis, Indiana.

Severe lower limb spasticity can hinder motor tasks and negatively impacts the quality of life in patients with cerebral palsy. Selective dorsal rhizotomy is a well-established neurosurgical intervention aimed at reducing muscle spasticity in patients with such neuromuscular conditions. Long-term outcomes of selective dorsal rhizotomy have been promising among the authors' institutional series of patients. In this case, we demonstrate the use of L1-S1 osteoplastic laminoplasty and L1-S1 selective dorsal rhizotomy in a 5-year-old male patient with cerebral palsy and spastic lower extremity diplegia. Favorable selection criteria for this case included disabling lower extremity diplegia, young age, good core strength, no cognitive delay, and strong rehabilitation potential. The patient's preoperative functional status was noncommunity ambulator (Gross Motor Function Classification System Level III) with walker use and good dynamic balance. Prior to the procedure, he demonstrated an overall decreased muscle strength in bilateral lower extremities with bilateral hamstring spasticity (Ashworth 3) and bilateral heel cord spasticity (Ashworth 4). Rhizotomy was performed with identification and selective sectioning of dorsal nerve roots with abnormal stimulation patterns. Fibers with unsustained discharge of appropriate muscles were identified and spared. No intraoperative or postoperative complications were encountered. The patient had minimal back pain and surgical morbidity postoperatively. Following the procedure and highly structured inpatient and outpatient rehabilitation therapies, the patient exhibited significant improvement in gait velocity (84%) and gait cadence (66%) at 5 months. Additionally, the patient demonstrated greater independence of activities of daily living and improvements in mobility by Pediatric Evaluation Disability Index. Patient consent was obtained from the parent.

UI MeSH Term Description Entries

Related Publications

Jacob Archer, and Alan P Yaacoub, and Francisco Angulo-Parker, and Gloria Fritsch, and Shana Riner, and Ann Coon, and Sarah K Johnson, and Sarah Delima, and Andrew Jea, and Jeffrey S Raskin
September 2019, Operative neurosurgery (Hagerstown, Md.),
Jacob Archer, and Alan P Yaacoub, and Francisco Angulo-Parker, and Gloria Fritsch, and Shana Riner, and Ann Coon, and Sarah K Johnson, and Sarah Delima, and Andrew Jea, and Jeffrey S Raskin
May 2022, World neurosurgery,
Jacob Archer, and Alan P Yaacoub, and Francisco Angulo-Parker, and Gloria Fritsch, and Shana Riner, and Ann Coon, and Sarah K Johnson, and Sarah Delima, and Andrew Jea, and Jeffrey S Raskin
January 1996, Journal of pediatric orthopedics,
Jacob Archer, and Alan P Yaacoub, and Francisco Angulo-Parker, and Gloria Fritsch, and Shana Riner, and Ann Coon, and Sarah K Johnson, and Sarah Delima, and Andrew Jea, and Jeffrey S Raskin
July 2019, Cureus,
Jacob Archer, and Alan P Yaacoub, and Francisco Angulo-Parker, and Gloria Fritsch, and Shana Riner, and Ann Coon, and Sarah K Johnson, and Sarah Delima, and Andrew Jea, and Jeffrey S Raskin
January 2017, Asian journal of neurosurgery,
Jacob Archer, and Alan P Yaacoub, and Francisco Angulo-Parker, and Gloria Fritsch, and Shana Riner, and Ann Coon, and Sarah K Johnson, and Sarah Delima, and Andrew Jea, and Jeffrey S Raskin
January 2015, Surgical neurology international,
Jacob Archer, and Alan P Yaacoub, and Francisco Angulo-Parker, and Gloria Fritsch, and Shana Riner, and Ann Coon, and Sarah K Johnson, and Sarah Delima, and Andrew Jea, and Jeffrey S Raskin
January 1994, Pediatric neurosurgery,
Jacob Archer, and Alan P Yaacoub, and Francisco Angulo-Parker, and Gloria Fritsch, and Shana Riner, and Ann Coon, and Sarah K Johnson, and Sarah Delima, and Andrew Jea, and Jeffrey S Raskin
July 2015, Acta neurochirurgica,
Jacob Archer, and Alan P Yaacoub, and Francisco Angulo-Parker, and Gloria Fritsch, and Shana Riner, and Ann Coon, and Sarah K Johnson, and Sarah Delima, and Andrew Jea, and Jeffrey S Raskin
November 1984, Journal of pediatric orthopedics,
Jacob Archer, and Alan P Yaacoub, and Francisco Angulo-Parker, and Gloria Fritsch, and Shana Riner, and Ann Coon, and Sarah K Johnson, and Sarah Delima, and Andrew Jea, and Jeffrey S Raskin
May 2023, Children (Basel, Switzerland),
Copied contents to your clipboard!