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Selective Dorsal Rhizotomy for the Treatment of Gait Dysfunction in Cerebral Palsy

A Critical Analysis Review

Chen, Brian Po-Jung PT, MD1,2; Wang, Kemble K. MBBS, FRACS1,3; Novacheck, Tom F. MD1,2

doi: 10.2106/JBJS.RVW.19.00020
Review Articles with Critical Analysis Component
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  • » Objective physical examination measures should be developed and improved to identify and measure spasticity and to differentiate it from other types of movement abnormalities.
  • » Using gait analysis as part of the preoperative evaluation of selective dorsal rhizotomy (SDR) can improve the safety and efficacy of this treatment of gait dysfunction in cerebral palsy.
  • » A multidisciplinary team is crucial when assessing and managing children with cerebral palsy because spasticity is only one disease component of cerebral palsy and differentiating between different types of hypertonia is challenging.
  • » A modest percentage of rootlet division (25% to 40%) reliably eliminates spasticity in cerebral palsy.
  • » Long-term studies have shown that SDR is safe and may improve certain aspects of function.

1Center for Gait and Motion Analysis, Gillette Children’s Specialty Healthcare, St. Paul, Minnesota

2Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, Minnesota

3Department of Orthopedic Surgery, Royal Children’s Hospital, Melbourne, Victoria, Australia

E-mail address for T.F. Novacheck: novac001@umn.edu

Investigation performed at the Center for Gait and Motion Analysis, Gillette Children’s Specialty Healthcare, St. Paul, Minnesota

Disclosure: The authors indicated that no external funding was received for any aspect of this work. The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJSREV/A497).

Copyright © 2019 by The Journal of Bone and Joint Surgery, Incorporated
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