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Comparative Study
. 2019 Jul 30;14(7):e0220119.
doi: 10.1371/journal.pone.0220119. eCollection 2019.

The short-term effects of selective dorsal rhizotomy on gait compared to matched cerebral palsy control groups

Rory O'Sullivan  1 , Jane Leonard  1 , Aoife Quinn  1 , Damien Kiernan  1
Affiliations
Comparative Study

The short-term effects of selective dorsal rhizotomy on gait compared to matched cerebral palsy control groups

Rory O'Sullivan et al. PLoS One. .

Abstract

Objectives: To examine the short-term effects of selective dorsal rhizotomy (SDR) ± soft-tissue surgery on gait in cerebral palsy (CP) compared to matched controls with no surgical intervention.

Methods: Participants had gait analysis before and one year after SDR. Non SDR participants were retrospectively matched for age and all significant gait parameters. The SDR group was further subdivided into those who had concomitant orthopaedic surgery and those who had SDR only.

Results: The SDR group consisted of 29 participants (mean age 5.8 years at baseline, 7.7 years at follow-up). Of these, 13 had concomitant orthopaedic surgery. The non SDR group consisted of 18 participants (mean age at baseline 6.1 years, 8.1 years at follow-up). SDR ± soft-tissue surgery significantly improved step-lengths, knee flexion at initial contact and mid-stance, ankle dorsiflexion, foot progression and timing of peak knee flexion. None of these improvements in gait were seen without surgical intervention. While more improvements were seen in those who had SDR and orthopaedic surgery, SDR only resulted in improved step-lengths, knee extension, foot progression and timing of peak knee flexion.

Conclusions: SDR ± soft-tissue surgery results in short-term improvements in gait which are not seen without surgical intervention. While those who had SDR and soft-tissue surgery demonstrated more changes in gait, many improvements were attributable to SDR only.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Comparison of gait kinematics pre and post operatively for SDR group (n = 29) and subsequent SnPM tests for the kinematic curves.
Kinematic graphs show Pre SDR (Red), Post SDR (Black). Shaded grey areas on SnPM curves to the right highlight the period of the gait cycle where the kinematic curves differed significantly.
Fig 2
Fig 2. Comparison of gait kinematics pre and post operatively for SDR Only group (n = 16) and subsequent SnPM tests for the kinematic curves.
Kinematic graphs show Pre SDR Only (Red), Post SDR Only (Black). Shaded grey areas on SnPM curves to the right highlight the period of the gait cycle where the kinematic curves differed significantly.
Fig 3
Fig 3. Comparison of gait kinematics pre and post operatively for SDR & Orthopaedic Surgery group (n = 13) and subsequent SnPM tests for the kinematic curves.
Kinematic graphs show Pre SDR & Orthopaedic Surgery (Red), Post SDR & Orthopaedic Surgery (Black). Shaded grey areas on SnPM curves to the right highlight the period of the gait cycle where the kinematic curves differed significantly.
See this image and copyright information in PMC

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