The use of minimally invasive techniques in multi-level surgery for children with cerebral palsy
Open Access
- 1 October 2010
- journal article
- research article
- Published by British Editorial Society of Bone & Joint Surgery in The Journal of Bone and Joint Surgery. British volume
- Vol. 92 (10), 1442-1448
- https://doi.org/10.1302/0301-620x.92b10.24307
Abstract
This study compares the initial outcomes of minimally invasive techniques for single-event multi-level surgery with conventional single-event multi-level surgery. The minimally invasive techniques included derotation osteotomies using closed corticotomy and fixation with titanium elastic nails and percutaneous lengthening of muscles where possible. A prospective cohort study of two matched groups was undertaken. Ten children with diplegic cerebral palsy with a mean age of ten years six months (7.11 to 13.9) had multi-level minimally invasive surgery and were matched for ambulatory level and compared with ten children with a mean age of 11 years four months (7.9 to 14.4) who had conventional single-event multi-level surgery. Gait kinematics, the Gillette Gait Index, isometric muscle strength and gross motor function were assessed before and 12 months after operation. The minimally invasive group had significantly reduced operation time and blood loss with a significantly improved time to mobilisation. There were no complications intra-operatively or during hospitalisation in either group. There was significant improvement in gait kinematics and the Gillette Gait Index in both groups with no difference between them. There was a trend to improved muscle strength in the multi-level group. There was no significant difference in gross motor function between the groups. We consider that minimally invasive single-event multi-level surgery can be achieved safely and effectively with significant advantages over conventional techniques in children with diplegic cerebral palsy.Keywords
This publication has 26 references indexed in Scilit:
- The natural history of gross motor development in children with cerebral palsy aged 1 to 15 yearsDevelopmental Medicine and Child Neurology, 2007
- Flexible intramedullary nails for fractures in childrenThe Journal of Bone and Joint Surgery. British volume, 2004
- Short‐term outcome of multilevel surgical intervention in spastic diplegic cerebral palsy compared with the natural historyDevelopmental Medicine and Child Neurology, 2004
- Femoral derotation osteotomy in spastic diplegiaThe Journal of Bone and Joint Surgery. British volume, 2003
- The Gross Motor Function Classification System for Cerebral Palsy: a study of reliability and stability over timeDevelopmental Medicine and Child Neurology, 2000
- An index for quantifying deviations from normal gaitGait & Posture, 2000
- Scaling gait data to body sizeGait & Posture, 1996
- Functional Changes in the Antagonists After Lengthening the Agonists in Cerebral PalsyPublished by Ovid Technologies (Wolters Kluwer Health) ,1990
- THE GROSS MOTOR FUNCTION MEASURE: A MEANS TO EVALUATE THE EFFECTS OF PHYSICAL THERAPYDevelopmental Medicine and Child Neurology, 1989
- PROLONGATIÓN OF WALKING IN DUCHENNE MUSCULAR DYSTROPHY WITH LIGHTWEIGHT ORTHOSES; REVIEW OF 57 CASESDevelopmental Medicine and Child Neurology, 1985