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The effect of selective dorsal rhizotomy on the improvement of the quality of life of children with stage GMFCS IV and V cerebral palsy: Pain, nursing, positioning, and dressing

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Abstract

Aim

The objective of this study is to evaluate the benefit of selective dorsal rhizotomy on the quality of life of patients with severe spasticity with significant impairment of gross motor functions (GMFCS stages IV and V) according to 4 items: pain, nursing care, positioning, and dressing.

Materials and methods

We conducted a monocentric retrospective cohort study including patients who underwent selective dorsal rhizotomy between March 2008 and May 2022 at the University Hospital of Marseille.

Results

Seventy percent of patients showed an improvement in quality of life criteria: dressing, nursing, positioning, and pain at the last follow-up. A small proportion of patients still showed a worsening between the first 2 follow-ups and the last follow-up.

Postoperatively, 27.3% of patients were free of joint spasticity treatment, and we have shown that there was a significant decrease in the number of children who received botulinum toxin postoperatively. However, there was no significant reduction in the number of drug treatments or orthopaedic procedures following RDS.

For the CPCHILD© scores, an overall gain is reported for GMFCS IV and V patients in postoperative care. The gain of points is more important for GMFCS IV patients. Improvement was mainly observed in 2 domains, “comfort and emotions” and “hygiene and dressing”. For the “quality of life” item, only 3 parents out of the 8 noted a positive change.

Conclusion

Our study shows an improvement in nursing care, positioning, and dressing which are associated with a reduction in pain in children with a major polyhandicap GMFCS IV and V who have benefited from a selective dorsal rhizotomy.

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References

  1. Enslin JMN, Langerak NG, Fieggen AG (2019) The evolution of selective dorsal rhizotomy for the management of spasticity. Neurotherapeutics 16(1):3–8

    Article  PubMed  Google Scholar 

  2. Grunt S, Becher JG, Vermeulen RJ (2011) Long-term outcome and adverse effects of selective dorsal rhizotomy in children with cerebral palsy: a systematic review: invited review. Dev Med Child Neurol 53(6):490–498

    Article  PubMed  Google Scholar 

  3. McLaughlin J, Bjornson K, Temkin N, Steinbok P, Wright V, Reiner A et al (2002) Selective dorsal rhizotomy: meta-analysis of three randomized controlled trials. Dev Med Child Neurol 44(1):17–25

    PubMed  Google Scholar 

  4. Steinbok P (2001) Outcomes after selective dorsal rhizotomy for spastic cerebral palsy. Childs Nerv Syst 17(1–2):1–18

    Article  CAS  PubMed  Google Scholar 

  5. Grunt S, Fieggen AG, Vermeulen RJ, Becher JG, Langerak NG (2014) Selection criteria for selective dorsal rhizotomy in children with spastic cerebral palsy: a systematic review of the literature. Dev Med Child Neurol 56(4):302–312

    Article  PubMed  Google Scholar 

  6. Kan P, Gooch J, Amini A, Ploeger D, Grams B, Oberg W et al (2008) Surgical treatment of spasticity in children: comparison of selective dorsal rhizotomy and intrathecal baclofen pump implantation. Childs Nerv Syst 24(2):239–243

    Article  PubMed  Google Scholar 

  7. D’Aquino D, Moussa AA, Ammar A, Ingale H, Vloeberghs M (2018) Selective dorsal rhizotomy for the treatment of severe spastic cerebral palsy: efficacy and therapeutic durability in GMFCS grade IV and V children. Acta Neurochir (Wien) 160(4):811–21

    Article  PubMed  Google Scholar 

  8. Viehweger E, Robitail S, Rohon MA, Jacquemier M, Jouve JL, Bollini G et al (2008) Mesure de la qualité de vie chez l’enfant atteint de paralysie cérébrale. Ann Réadapt Médecine Phys 51(2):119–128

    Article  CAS  Google Scholar 

  9. Narayanan UG, Fehlings D, Weir S, Knights S, Kiran S, Campbell K (2006) Initial development and validation of the Caregiver Priorities and Child Health Index of Life with Disabilities (CPCHILD). Dev Med Child Neurol 48(10):804–812

    Article  PubMed  Google Scholar 

  10. Buizer AI, van Schie PEM, Bolster EAM, van Ouwerkerk WJ, Strijers RL, van de Pol LA et al (2017) Effect of selective dorsal rhizotomy on daily care and comfort in non-walking children and adolescents with severe spasticity. Eur J Paediatr Neurol 21(2):350–357

    Article  CAS  PubMed  Google Scholar 

  11. Hosseinzadeh P, Baldwin K, Minaie A, Miller F (2020) Management of hip disorders in patients with cerebral palsy. JBJS Rev 8(3):e0148–e0148

    Article  PubMed  Google Scholar 

  12. Gu Y, Shelton JE, Ketchum JM, Cifu DX, Palmer D, Sparkman A et al (2011) Natural history of scoliosis in nonambulatory spastic tetraplegic cerebral palsy. PM&R 3(1):27–32

    Article  Google Scholar 

  13. Cole GF, Farmer SE, Roberts A, Stewart C, Patrick JH (2007) Selective dorsal rhizotomy for children with cerebral palsy: the Oswestry experience. Arch Dis Child 92(9):781–5

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Chicoine MR, Park TS, Kaufman BA (1997) Selective dorsal rhizotomy and rates of orthopedic surgery in children with spastic cerebral palsy. J Neurosurg 86(1):34–39

    Article  CAS  PubMed  Google Scholar 

  15. O’Brien DF, Park TS, Puglisi JA, Collins DR, Leuthardt EC, Leonard JR (2005) Orthopedic surgery after selective dorsal rhizotomy for spastic diplegia in relation to ambulatory status and age. J Neurosurg Pediatr 103(1):5–9

    Article  Google Scholar 

  16. Makris T, Dorstyn D, Crettenden A (2021) Quality of life in children and adolescents with cerebral palsy: a systematic review with meta-analysis. Disabil Rehabil 43(3):299–308

    Article  PubMed  Google Scholar 

  17. Craft S, Park TS, White DA, Schatz J, Noetzel M, Arnold S (1995) Changes in cognitive performance in children with spastic diplegic cerebral palsy following selective dorsal rhizotomy. Pediatr Neurosurg 23(2):68–75

    Article  CAS  PubMed  Google Scholar 

  18. Krasny-Pacini A, Hiebel J, Pauly F, Godon S, Chevignard M (2013) Goal attainment scaling in rehabilitation: a literature-based update. Ann Phys Rehabil Med 56(3):212–230

    Article  CAS  PubMed  Google Scholar 

  19. Vargus-Adams JN, Majnemer A (2014) International classification of functioning, disability and health (ICF) as a framework for change: revolutionizing rehabilitation. J Child Neurol 29(8):1030–1035

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Rehabilitation, CHU Timone, Marseille, France

    Jeanne Meyer-Sauvage & Jean-Michel Viton

  2. Department of Pediatric Neurosurgery, CHU Timone Enfant, Marseille, France

    Manel Krouma, Caroline Klovan & Didier Scavarda

  3. Department of Pediatric Rehabilitation, Institut Pomponiana, Hyeres, France

    Philippe Bardot & Marie-Ange Rohon

  4. Department of Pediatric Orthopedic Surgery, CHU Timone, Marseille, France

    Christophe Boulay

Authors
  1. Jeanne Meyer-Sauvage
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  2. Manel Krouma
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  3. Caroline Klovan
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  4. Philippe Bardot
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  5. Marie-Ange Rohon
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  6. Jean-Michel Viton
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  7. Christophe Boulay
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  8. Didier Scavarda
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Contributions

JMS, MK, CK and DS wrote the main manuscript; PB and MAR studied the bibliography; JMV and CB reviewed the manuscript; JMS and DS elaborated the aim and methodology of the study.

Corresponding author

Correspondence to Didier Scavarda.

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Meyer-Sauvage, J., Krouma, M., Klovan, C. et al. The effect of selective dorsal rhizotomy on the improvement of the quality of life of children with stage GMFCS IV and V cerebral palsy: Pain, nursing, positioning, and dressing. Childs Nerv Syst 40, 987–995 (2024). https://doi.org/10.1007/s00381-024-06321-y

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