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A SELECTIVE PROGRAMME OF DORSAL RHIZOTOMY FOR DIPLEGIA.



Abstract

Introduction: Selective dorsal rhizotomy has been used extensively in Europe and North America in the management of spasticity secondary to cerebral palsy. Permanent reduction in lower limb spasticity has been observed with consequent improvements in gait parameters. A decade ago a rhizotomy programme was established in Oswestry to utilise the technique for a carefully monitored group of children with cerebral palsy diplegia.

Methods: Using stringent selection criteria, twenty children underwent selective lumbar dorsal rhizotomy with follow up by means of gait analysis. A permanent reduction in spasticity has been observed with a significant improvement in almost all parameters. We report the need for further bony and soft tissue surgery and our complications. There has been weight gain in the majority of cases. There has been no major spinal deformity.

Conclusion: As a result of our review of the results in the first twenty cerebral palsy diplegic patients we have modified our selection criteria. Exclusion criteria include weakness, not enough spasticity or poor control.

The abstracts were prepared by Editorial Secretary, Mr Robin W Paton. Correspondence should be addressed to BSCOS at the Royal College of Surgeons, 35– 43 Lincoln’s Inn Fields, London WC2A 3PN