Selective dorsal rhizotomy opportunities with foot deformitiesin children with cerebral palsy

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Abstract


Foot deformities are the most common orthopedic condition in children with cerebral palsy. The aim of the study was to evaluate the influence of selective dorsal rhizotomy (SDR) on foot deformities in children with cerebral palsy. The results were assessed clinically by measurement of changes in muscle spaticity and foot posture. Percentage of resection of dorsal rootlets was from 40 to 90 % of total thickness. The degree of tone reduction had a tendency to be more pronounced in the more proximal muscles and was minimal in calf muscles. Nevertheless, foot posture improved more significantly. That can be explained by generalimprovement of pathological posture at the level of more proximal joints. Thus, SDR has insignificant direct effect on spastic foot deformity and can not be recommended as a basic method of treatment even in pure spasticity. However, SDR should be considered as a part of multidisciplinary management protocol if foot deformity reflects more complex postural disturbance due to generalized spasticity.

Vladimir Markovich Kenis

The Turner Institute for Children’s Orthopedics, Saint-Petersburg

Email: kenis@mail.ru
MD, PhD, professor, head of the department of foot pathology, neuroorthopedics and systemic diseases. FSBI “Scientific and Research Institute for Children’s Orthopedics n. a. G. I. Turner” under the Ministry of Health of the Russian Federation

Stanislav Vyacheslavovich Ivanov

The Turner Institute for Children’s Orthopedics, Saint-Petersburg

MD, research associate of the department of foot pathology, neuroorthopedics and systemic diseases. FSBI “Scientific and Research Institute for Children’s Orthopedics n. a. G. I. Turner” under the Ministry of Health of the Russian Federation

Tatiana Ilinichna Kiseleva

The Turner Institute for Children’s Orthopedics, Saint-Petersburg

MD, orthopedic and trauma surgeon of the department of foot pathology, neuroorthopedics and systemic diseases. FSBI “Scientific and Research Institute for Children’s Orthopedics n. a. G. I. Turner” under the Ministry of Health of the Russian Federation

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Copyright (c) 2015 Kenis V.M., Ivanov S.V., Kiseleva T.I.

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