Cerebral palsy surgery

Jump to: navigation, search

Cerebral palsy Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Cerebral Palsy from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Criteria

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X-ray

Echocardiography and Ultrasound

CT scan

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Cerebral palsy surgery On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Cerebral palsy surgery

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Cerebral palsy surgery

CDC on Cerebral palsy surgery

Cerebral palsy surgery in the news

Blogs on Cerebral palsy surgery

Directions to Hospitals Treating Psoriasis

Risk calculators and risk factors for Cerebral palsy surgery

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ahmed Younes M.B.B.CH [2]

Overview

Surgery is not the first-line treatment option for patients with cerebral palsy. Surgery is usually reserved for patients with severe disease causing functional abnormalities. Surgical interventions include selective dorsal rhizotomy and tendon lengthening or transfer.

Surgery

Selective dorsal rhizotomy

  • The main neurosurgical intervention for cerebral palsy.[1]
  • It involves dissecting some of the afferent nerve fibers in the lumbosacral roots.
  • This results in decreasing the muscle tone by disrupting the reflex arch without affecting the motor power.
  • Selective dorsal rhizotomy is proven to improve the muscle strength and the range of motion.[2]
  • In certain patients, weakness develops after performing the procedure. The weakness is thought to be unmasked by the relief of spasticity.[3]

Tendon lengthening or transfer

  • Tendon manipulations are done when the contracture is interfering with the movement significantly.[4]
  • It might improve the range of motion and the ability to ambulate.[5]

References

  1. Engsberg JR, Ross SA, Collins DR, Park TS (2006). "Effect of selective dorsal rhizotomy in the treatment of children with cerebral palsy". J. Neurosurg. 105 (1 Suppl): 8–15. doi:10.3171/ped.2006.105.1.8. PMC 2423424. PMID 16871864.
  2. 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. doi:10.1136/adc.2006.111559. PMC 2084010. PMID 17475694.
  3. 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): 302–12. doi:10.1111/dmcn.12277. PMID 24106928.
  4. Vlachou M, Pierce R, Davis RM, Sussman M (2009). "Does tendon lengthening surgery affect muscle tone in children with cerebral palsy?". Acta Orthop Belg. 75 (6): 808–14. PMID 20166364.
  5. Abel MF, Damiano DL, Pannunzio M, Bush J (1999). "Muscle-tendon surgery in diplegic cerebral palsy: functional and mechanical changes". J Pediatr Orthop. 19 (3): 366–75. PMID 10344322.

Linked-in.jpg