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Long‐term impact of childhood selective dorsal rhizotomy on pain, fatigue, and function: a case–control study
Author(s) -
Daunter Alecia K,
Kratz Anna L,
Hurvitz Edward A
Publication year - 2017
Publication title -
developmental medicine and child neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.658
H-Index - 143
eISSN - 1469-8749
pISSN - 0012-1622
DOI - 10.1111/dmcn.13481
Subject(s) - rhizotomy , cerebral palsy , gross motor function classification system , spasticity , medicine , physical therapy , gross motor skill , physical medicine and rehabilitation , dorsum , anesthesia , motor skill , psychiatry , anatomy
Aim Selective dorsal rhizotomy ( SDR ) is a surgical treatment for spasticity in children with cerebral palsy ( CP ). Studies suggest long‐lasting effects of SDR on spasticity; long‐term effects on symptoms and function are not clear. This study tested whether adults with CP (average 22y after SDR ) report less pain, fatigue, and functional decline than a retrospectively assessed non‐surgical comparison group. Method This was a case–control study. Eighty‐eight adults with CP (mean age 27y; SDR =38 male/female/missing=20/16/2; non‐surgical [comparison]=50, male/female=19/31) recruited from a tertiary care center and the community completed a battery of self‐reported outcome measures. Regression models were used to test whether SDR status predicted pain, fatigue, functional change, and hours of assistance (controlling for Gross Motor Function Classification System level). Results SDR status did not significantly predict pain interference ( p =0.965), pain intensity ( p =0.512), or fatigue ( p =0.404). SDR related to lower decline in gross motor functioning ( p =0.010) and approximately 6 fewer hours of daily assistance than for those in the comparison group ( p =0.001). Interpretation Adults with CP who had SDR in childhood reported less gross motor decline and fewer daily assistance needs than non‐surgically treated peers, suggesting the functional impact of SDR persists long after surgery.