Effect of selective dorsal rhizotomy on daily care and comfort in non-walking children and adolescents with severe spasticity

A. I. Buizer; P. E. M. van Schie; E. A. M. Bolster; W. J. van Ouwerkerk; R. L. Strijers; L. A. van de Pol; A. Stadhouder; J. G. Becher; R. J. Vermeulen

doi:10.1016/j.ejpn.2016.09.006

Effect of selective dorsal rhizotomy on daily care and comfort in non-walking children and adolescents with severe spasticity

A. I. Buizer^*, P. E. M. van Schie, E. A. M. Bolster, W. J. van Ouwerkerk, R. L. Strijers, L. A. van de Pol, A. Stadhouder, J. G. Becher, R. J. Vermeulen

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Background: In non-walking children with severe spasticity, daily care can be difficult and many patients suffer from pain. Selective dorsal rhizotomy (SDR) reduces spasticity in the legs, and therefore has the potential to improve daily care and comfort.

Aim: To examine effects of SDR on daily care and comfort in non-walking children with severe spasticity due to different underlying neurological conditions.

Methods: Medical history, changes in daily care and comfort and satisfaction with outcome were assessed retrospectively in non-walking children who underwent SDR in our center, with a mean follow-up of 1y 7m (range 11m-4y 3m). All eligible patients (n = 24, years 2009 2014) were included.

Results: Mean age at SDR was 12y 4m (SD 4y 3m, range 2y 8m-19y 3m). Associated orthopaedic problems were frequent. Seven patients underwent scoliosis correction in the same session. Most improvements were reported in dressing (n = 16), washing (n = 12) and comfort (n = 10). Median score for satisfaction was 7 on a scale of 10 (range 1-9). SDR resulted in reduction of spasticity in leg muscles. In nine patients dystonia was recorded post-operatively, mainly in children with congenital malformations and syndromes.

Interpretation: SDR is a single event intervention that can improve daily care and comfort in non-walking children with severe spasticity, and can safely be combined with scoliosis correction. Despite the improvements, satisfaction is variable. Careful attention is necessary for risk factors for dystonia, which may be unmasked after SDR. (C) 2016 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

Original language	English
Pages (from-to)	350-357
Number of pages	8
Journal	European Journal of Paediatric Neurology
Volume	21
Issue number	2
DOIs	https://doi.org/10.1016/j.ejpn.2016.09.006
Publication status	Published - Mar 2017

Keywords

Cerebral palsy
Surgery
Intervention
SDR
Scoliosis
Pain
INTRATHECAL BACLOFEN THERAPY
GROSS MOTOR FUNCTION
QUALITY-OF-LIFE
CEREBRAL-PALSY
ADULTS
ORIGIN
PAIN

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Buizer, A. I., van Schie, P. E. M., Bolster, E. A. M., van Ouwerkerk, W. J., Strijers, R. L., van de Pol, L. A., Stadhouder, A., Becher, J. G., & Vermeulen, R. J. (2017). Effect of selective dorsal rhizotomy on daily care and comfort in non-walking children and adolescents with severe spasticity. European Journal of Paediatric Neurology, 21(2), 350-357. https://doi.org/10.1016/j.ejpn.2016.09.006

@article{015a193f5519404789ff3d8cb467c3b0,

title = "Effect of selective dorsal rhizotomy on daily care and comfort in non-walking children and adolescents with severe spasticity",

abstract = "Background: In non-walking children with severe spasticity, daily care can be difficult and many patients suffer from pain. Selective dorsal rhizotomy (SDR) reduces spasticity in the legs, and therefore has the potential to improve daily care and comfort.Aim: To examine effects of SDR on daily care and comfort in non-walking children with severe spasticity due to different underlying neurological conditions.Methods: Medical history, changes in daily care and comfort and satisfaction with outcome were assessed retrospectively in non-walking children who underwent SDR in our center, with a mean follow-up of 1y 7m (range 11m-4y 3m). All eligible patients (n = 24, years 2009 2014) were included.Results: Mean age at SDR was 12y 4m (SD 4y 3m, range 2y 8m-19y 3m). Associated orthopaedic problems were frequent. Seven patients underwent scoliosis correction in the same session. Most improvements were reported in dressing (n = 16), washing (n = 12) and comfort (n = 10). Median score for satisfaction was 7 on a scale of 10 (range 1-9). SDR resulted in reduction of spasticity in leg muscles. In nine patients dystonia was recorded post-operatively, mainly in children with congenital malformations and syndromes.Interpretation: SDR is a single event intervention that can improve daily care and comfort in non-walking children with severe spasticity, and can safely be combined with scoliosis correction. Despite the improvements, satisfaction is variable. Careful attention is necessary for risk factors for dystonia, which may be unmasked after SDR. (C) 2016 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.",

keywords = "Cerebral palsy, Surgery, Intervention, SDR, Scoliosis, Pain, INTRATHECAL BACLOFEN THERAPY, GROSS MOTOR FUNCTION, QUALITY-OF-LIFE, CEREBRAL-PALSY, ADULTS, ORIGIN, PAIN",

author = "Buizer, {A. I.} and {van Schie}, {P. E. M.} and Bolster, {E. A. M.} and {van Ouwerkerk}, {W. J.} and Strijers, {R. L.} and {van de Pol}, {L. A.} and A. Stadhouder and Becher, {J. G.} and Vermeulen, {R. J.}",

year = "2017",

month = mar,

doi = "10.1016/j.ejpn.2016.09.006",

language = "English",

volume = "21",

pages = "350--357",

journal = "European Journal of Paediatric Neurology",

issn = "1090-3798",

publisher = "W.B. Saunders Ltd",

number = "2",

}

Buizer, AI, van Schie, PEM, Bolster, EAM, van Ouwerkerk, WJ, Strijers, RL, van de Pol, LA, Stadhouder, A, Becher, JG & Vermeulen, RJ 2017, 'Effect of selective dorsal rhizotomy on daily care and comfort in non-walking children and adolescents with severe spasticity', European Journal of Paediatric Neurology, vol. 21, no. 2, pp. 350-357. https://doi.org/10.1016/j.ejpn.2016.09.006

TY - JOUR

T1 - Effect of selective dorsal rhizotomy on daily care and comfort in non-walking children and adolescents with severe spasticity

AU - Buizer, A. I.

AU - van Schie, P. E. M.

AU - Bolster, E. A. M.

AU - van Ouwerkerk, W. J.

AU - Strijers, R. L.

AU - van de Pol, L. A.

AU - Stadhouder, A.

AU - Becher, J. G.

AU - Vermeulen, R. J.

PY - 2017/3

Y1 - 2017/3

N2 - Background: In non-walking children with severe spasticity, daily care can be difficult and many patients suffer from pain. Selective dorsal rhizotomy (SDR) reduces spasticity in the legs, and therefore has the potential to improve daily care and comfort.Aim: To examine effects of SDR on daily care and comfort in non-walking children with severe spasticity due to different underlying neurological conditions.Methods: Medical history, changes in daily care and comfort and satisfaction with outcome were assessed retrospectively in non-walking children who underwent SDR in our center, with a mean follow-up of 1y 7m (range 11m-4y 3m). All eligible patients (n = 24, years 2009 2014) were included.Results: Mean age at SDR was 12y 4m (SD 4y 3m, range 2y 8m-19y 3m). Associated orthopaedic problems were frequent. Seven patients underwent scoliosis correction in the same session. Most improvements were reported in dressing (n = 16), washing (n = 12) and comfort (n = 10). Median score for satisfaction was 7 on a scale of 10 (range 1-9). SDR resulted in reduction of spasticity in leg muscles. In nine patients dystonia was recorded post-operatively, mainly in children with congenital malformations and syndromes.Interpretation: SDR is a single event intervention that can improve daily care and comfort in non-walking children with severe spasticity, and can safely be combined with scoliosis correction. Despite the improvements, satisfaction is variable. Careful attention is necessary for risk factors for dystonia, which may be unmasked after SDR. (C) 2016 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

AB - Background: In non-walking children with severe spasticity, daily care can be difficult and many patients suffer from pain. Selective dorsal rhizotomy (SDR) reduces spasticity in the legs, and therefore has the potential to improve daily care and comfort.Aim: To examine effects of SDR on daily care and comfort in non-walking children with severe spasticity due to different underlying neurological conditions.Methods: Medical history, changes in daily care and comfort and satisfaction with outcome were assessed retrospectively in non-walking children who underwent SDR in our center, with a mean follow-up of 1y 7m (range 11m-4y 3m). All eligible patients (n = 24, years 2009 2014) were included.Results: Mean age at SDR was 12y 4m (SD 4y 3m, range 2y 8m-19y 3m). Associated orthopaedic problems were frequent. Seven patients underwent scoliosis correction in the same session. Most improvements were reported in dressing (n = 16), washing (n = 12) and comfort (n = 10). Median score for satisfaction was 7 on a scale of 10 (range 1-9). SDR resulted in reduction of spasticity in leg muscles. In nine patients dystonia was recorded post-operatively, mainly in children with congenital malformations and syndromes.Interpretation: SDR is a single event intervention that can improve daily care and comfort in non-walking children with severe spasticity, and can safely be combined with scoliosis correction. Despite the improvements, satisfaction is variable. Careful attention is necessary for risk factors for dystonia, which may be unmasked after SDR. (C) 2016 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

KW - Cerebral palsy

KW - Surgery

KW - Intervention

KW - SDR

KW - Scoliosis

KW - Pain

KW - INTRATHECAL BACLOFEN THERAPY

KW - GROSS MOTOR FUNCTION

KW - QUALITY-OF-LIFE

KW - CEREBRAL-PALSY

KW - ADULTS

KW - ORIGIN

KW - PAIN

U2 - 10.1016/j.ejpn.2016.09.006

DO - 10.1016/j.ejpn.2016.09.006

M3 - Article

SN - 1090-3798

VL - 21

SP - 350

EP - 357

JO - European Journal of Paediatric Neurology

JF - European Journal of Paediatric Neurology

IS - 2

ER -

Effect of selective dorsal rhizotomy on daily care and comfort in non-walking children and adolescents with severe spasticity

Abstract

Keywords

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