A comparison of conventional and minimally invasive multilevel surgery for children with diplegic cerebral palsy
- 1 January 2021
- journal article
- research article
- Published by British Editorial Society of Bone & Joint Surgery in The Bone & Joint Journal
- Vol. 103-B (1), 192-197
- https://doi.org/10.1302/0301-620x.103b1.bjj-2020-0714.r1
Abstract
Aims To compare changes in gait kinematics and walking speed 24 months after conventional (C-MLS) and minimally invasive (MI-MLS) multilevel surgery for children with diplegic cerebral palsy (CP). Methods A retrospective analysis of 19 children following C-MLS, with mean age at surgery of 12 years five months (seven years ten months to 15 years 11 months), and 36 children following MI-MLS, with mean age at surgery of ten years seven months (seven years one month to 14 years ten months), was performed. The Gait Profile Score (GPS) and walking speed were collected preoperatively and six, 12 and 24 months postoperatively. Type and frequency of procedures as part of MLS, surgical adverse events, and subsequent surgery were recorded. Results In both groups, GPS improved from the preoperative gait analysis to the six-month assessment with maintenance at 12 and 24 months postoperatively. While reduced at six months in both groups, walking speed returned to preoperative speed by 12 months. The overall pattern of change in GPS and walking speed was similar over time following C-MLS and MI-MLS. There was a median of ten procedures per child as part of both C-MLS (interquartile range (IQR) 8.0 to 11.0) and MI-MLS (IQR 7.8 to 11.0). Surgical adverse events occurred in seven (37%) and 13 (36%) children, with four (21%) and 13 (36%) patients requiring subsequent surgery following C-MLS and MI-MLS, respectively. Conclusion This study indicates similar improvements in gait kinematics and walking speed 24 months after C-MLS and MI-MLS for children with diplegic CP. Cite this article: Bone Joint J 2021;103-B(1):192–197.Keywords
This publication has 16 references indexed in Scilit:
- Reliability of the Modified Clavien-Dindo-Sink Complication Classification System in Pediatric Orthopaedic SurgeryJB & JS open access, 2018
- Single‐event multilevel surgery for children with cerebral palsy: a systematic reviewDevelopmental Medicine and Child Neurology, 2011
- Single-Event Multilevel Surgery in Children with Spastic DiplegiaJournal of Bone and Joint Surgery, 2011
- The use of minimally invasive techniques in multi-level surgery for children with cerebral palsyThe Journal of Bone and Joint Surgery. British volume, 2010
- The Gait Profile Score and Movement Analysis ProfileGait & Posture, 2009
- Recovery of muscle strength following multi-level orthopaedic surgery in diplegic cerebral palsyGait & Posture, 2007
- OPTIMIZATION OF WALKING ABILITY OF CHILDREN WITH CEREBRAL PALSYThe Journal of Bone and Joint Surgery-American Volume, 2003
- Comparison of Proximal and Distal Rotational Femoral Osteotomy in Children With Cerebral PalsyJournal of Pediatric Orthopaedics, 2003
- Which Implant for Proximal Femoral Osteotomy in Children? A Comparison of the AO (ASIF) 90° Fixed-Angle Blade Plate and the Richards Intermediate Hip ScrewJournal of Pediatric Orthopaedics, 2000
- Development and reliability of a system to classify gross motor function in children with cerebral palsyDevelopmental Medicine and Child Neurology, 1997