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Journal of Pediatric Orthopaedics:
doi: 10.1097/BPO.0b013e3181e00c98
Cerebral Palsy

Issues of Concern Before Single Event Multilevel Surgery in Patients With Cerebral Palsy

Park, Moon Seok MD*; Chung, Chin Youb MD*; Lee, Kyoung Min MD*; Lee, Sang Hyeong MD*; Choi, In Ho MD; Cho, Tae-Joon MD; Yoo, Won Joon MD; Kim, Kyung Hwan MD*

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Background: This study was performed to identify the issues of concern of parents of patients with cerebral palsy before single event multilevel surgery (SEMS).

Methods: The parental concerns of 64 patients [34 males, 30 females, mean age 15 y and 5 mo (SD 8 y and 10 mo)] with cerebral palsy were obtained using a questionnaire preoperatively. The issues of parental concern were evaluated using 59 items specifically designed for this study. The individual items were scored using a 5-point Likert scale (1 to 5).

Results: The top 5 issues of concern were as follows: postoperative rehabilitation, duration of rehabilitation, immediate postoperative pain, general anesthesia, and medical cost. Sporting activities and poor compliance to wearing orthosis were included in the top 5 issues of parental concern in patients with unilateral involvement. The overall parental concern in patients with unilateral involvement was lower than that in bilateral involvement (P=0.054). Parents of younger patients showed significantly higher concern score than those of older patients (P=0.020). There was no significant difference in the overall concern score between the parents of patients scheduled for bony procedures and those of patients scheduled for soft tissue procedures (P=0.298). Multiple regression analysis revealed the patient's age (P=0.018) and responding parent (father vs. mother, P=0.025) to be the factors that significantly affected the overall concern score (adjusted R2=0.281).

Conclusions: An understanding of the issues of concern will enhance communication between physicians and parents, which would assist in preoperative discussion.

Level of Evidence: Diagnostic level II.

© 2010 Lippincott Williams & Wilkins, Inc.

The Pediatric Orthopaedic Society of North America (POSNA)
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