SPINAL DEFORMITIES AFTER SELECTIVE DORSAL RHIZOTOMY
Autor(a) principal: | |
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Data de Publicação: | 2016 |
Outros Autores: | , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Coluna/Columna |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1808-18512016000300186 |
Resumo: | ABSTRACT Objective: Selective dorsal rhizotomy (SDR) used for spasticity treatment could worsen or develop spinal deformities. Our goal is to describe spinal deformities seen in patients with cerebral palsy (CP) after being treated by SDR. Methods: Retrospective study of patients operated on (SDR) between January/1999 and June/2012. Inclusion criteria: spinal Rx before SDR surgery, spinography, and assessment at follow-up. We evaluated several factors emphasizing level and type of SDR approach, spinal deformity and its treatment, final Risser, and follow-up duration. Results: We found 7 patients (6 males): mean age at SDR 7.56 years (4.08-11.16). Mean follow-up: 6.64 years (2.16-13), final age: 14.32 years (7.5-19). No patient had previous deformity. GMFCS: 2 patients level IV, 2 level III, 3 level II. Initial walking status: 2 community walkers, 2 household walkers, 2 functional walkers, 1 not ambulant, at the follow-up, 3 patients improved, and 4 kept their status. We found 4 TL/L laminotomies, 2 L/LS laminectomies, and 1 thoracic laminectomy. Six spinal deformities were observed: 2 sagittal, 3 mixed, and 1 scoliosis. There was no association among the type of deformity, final gait status, topographic type, GMFCS, age, or SDR approach. Three patients had surgery indication for spinal deformity at skeletal maturity, while those patients with smaller deformities were still immature (Risser 0 to 2/3) although with progressive curves. Conclusions: After SDR, patients should be periodically evaluated until they reach Risser 5. The development of a deformity does not compromise functional results but adds morbidity because it may require surgical treatment. |
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SPINAL DEFORMITIES AFTER SELECTIVE DORSAL RHIZOTOMYCerebral palsyMuscle spasticityRhizotomyScoliosisABSTRACT Objective: Selective dorsal rhizotomy (SDR) used for spasticity treatment could worsen or develop spinal deformities. Our goal is to describe spinal deformities seen in patients with cerebral palsy (CP) after being treated by SDR. Methods: Retrospective study of patients operated on (SDR) between January/1999 and June/2012. Inclusion criteria: spinal Rx before SDR surgery, spinography, and assessment at follow-up. We evaluated several factors emphasizing level and type of SDR approach, spinal deformity and its treatment, final Risser, and follow-up duration. Results: We found 7 patients (6 males): mean age at SDR 7.56 years (4.08-11.16). Mean follow-up: 6.64 years (2.16-13), final age: 14.32 years (7.5-19). No patient had previous deformity. GMFCS: 2 patients level IV, 2 level III, 3 level II. Initial walking status: 2 community walkers, 2 household walkers, 2 functional walkers, 1 not ambulant, at the follow-up, 3 patients improved, and 4 kept their status. We found 4 TL/L laminotomies, 2 L/LS laminectomies, and 1 thoracic laminectomy. Six spinal deformities were observed: 2 sagittal, 3 mixed, and 1 scoliosis. There was no association among the type of deformity, final gait status, topographic type, GMFCS, age, or SDR approach. Three patients had surgery indication for spinal deformity at skeletal maturity, while those patients with smaller deformities were still immature (Risser 0 to 2/3) although with progressive curves. Conclusions: After SDR, patients should be periodically evaluated until they reach Risser 5. The development of a deformity does not compromise functional results but adds morbidity because it may require surgical treatment.Sociedade Brasileira de Coluna2016-09-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1808-18512016000300186Coluna/Columna v.15 n.3 2016reponame:Coluna/Columnainstname:Sociedade Brasileira de Coluna (SBCO)instacron:SBCO10.1590/S1808-185120161503149860info:eu-repo/semantics/openAccessPABLO MANZONE,PATRICIOVALLEJOS ARCE,MARÍA SELVAORSINI,EDITHDORTIGNAC,MARIANOMARIÑO AVALOS,EDUARDOCARDOZO IÑIGUEZ,MARIA LORENAGEMETRO,JOSÉeng2016-09-23T00:00:00Zoai:scielo:S1808-18512016000300186Revistahttps://www.revistacoluna.org/ONGhttps://old.scielo.br/oai/scielo-oai.phpcoluna.columna@uol.com.br||revistacoluna@uol.com.br2177-014X1808-1851opendoar:2016-09-23T00:00Coluna/Columna - Sociedade Brasileira de Coluna (SBCO)false |
dc.title.none.fl_str_mv |
SPINAL DEFORMITIES AFTER SELECTIVE DORSAL RHIZOTOMY |
title |
SPINAL DEFORMITIES AFTER SELECTIVE DORSAL RHIZOTOMY |
spellingShingle |
SPINAL DEFORMITIES AFTER SELECTIVE DORSAL RHIZOTOMY PABLO MANZONE,PATRICIO Cerebral palsy Muscle spasticity Rhizotomy Scoliosis |
title_short |
SPINAL DEFORMITIES AFTER SELECTIVE DORSAL RHIZOTOMY |
title_full |
SPINAL DEFORMITIES AFTER SELECTIVE DORSAL RHIZOTOMY |
title_fullStr |
SPINAL DEFORMITIES AFTER SELECTIVE DORSAL RHIZOTOMY |
title_full_unstemmed |
SPINAL DEFORMITIES AFTER SELECTIVE DORSAL RHIZOTOMY |
title_sort |
SPINAL DEFORMITIES AFTER SELECTIVE DORSAL RHIZOTOMY |
author |
PABLO MANZONE,PATRICIO |
author_facet |
PABLO MANZONE,PATRICIO VALLEJOS ARCE,MARÍA SELVA ORSINI,EDITH DORTIGNAC,MARIANO MARIÑO AVALOS,EDUARDO CARDOZO IÑIGUEZ,MARIA LORENA GEMETRO,JOSÉ |
author_role |
author |
author2 |
VALLEJOS ARCE,MARÍA SELVA ORSINI,EDITH DORTIGNAC,MARIANO MARIÑO AVALOS,EDUARDO CARDOZO IÑIGUEZ,MARIA LORENA GEMETRO,JOSÉ |
author2_role |
author author author author author author |
dc.contributor.author.fl_str_mv |
PABLO MANZONE,PATRICIO VALLEJOS ARCE,MARÍA SELVA ORSINI,EDITH DORTIGNAC,MARIANO MARIÑO AVALOS,EDUARDO CARDOZO IÑIGUEZ,MARIA LORENA GEMETRO,JOSÉ |
dc.subject.por.fl_str_mv |
Cerebral palsy Muscle spasticity Rhizotomy Scoliosis |
topic |
Cerebral palsy Muscle spasticity Rhizotomy Scoliosis |
description |
ABSTRACT Objective: Selective dorsal rhizotomy (SDR) used for spasticity treatment could worsen or develop spinal deformities. Our goal is to describe spinal deformities seen in patients with cerebral palsy (CP) after being treated by SDR. Methods: Retrospective study of patients operated on (SDR) between January/1999 and June/2012. Inclusion criteria: spinal Rx before SDR surgery, spinography, and assessment at follow-up. We evaluated several factors emphasizing level and type of SDR approach, spinal deformity and its treatment, final Risser, and follow-up duration. Results: We found 7 patients (6 males): mean age at SDR 7.56 years (4.08-11.16). Mean follow-up: 6.64 years (2.16-13), final age: 14.32 years (7.5-19). No patient had previous deformity. GMFCS: 2 patients level IV, 2 level III, 3 level II. Initial walking status: 2 community walkers, 2 household walkers, 2 functional walkers, 1 not ambulant, at the follow-up, 3 patients improved, and 4 kept their status. We found 4 TL/L laminotomies, 2 L/LS laminectomies, and 1 thoracic laminectomy. Six spinal deformities were observed: 2 sagittal, 3 mixed, and 1 scoliosis. There was no association among the type of deformity, final gait status, topographic type, GMFCS, age, or SDR approach. Three patients had surgery indication for spinal deformity at skeletal maturity, while those patients with smaller deformities were still immature (Risser 0 to 2/3) although with progressive curves. Conclusions: After SDR, patients should be periodically evaluated until they reach Risser 5. The development of a deformity does not compromise functional results but adds morbidity because it may require surgical treatment. |
publishDate |
2016 |
dc.date.none.fl_str_mv |
2016-09-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1808-18512016000300186 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1808-18512016000300186 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1590/S1808-185120161503149860 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Sociedade Brasileira de Coluna |
publisher.none.fl_str_mv |
Sociedade Brasileira de Coluna |
dc.source.none.fl_str_mv |
Coluna/Columna v.15 n.3 2016 reponame:Coluna/Columna instname:Sociedade Brasileira de Coluna (SBCO) instacron:SBCO |
instname_str |
Sociedade Brasileira de Coluna (SBCO) |
instacron_str |
SBCO |
institution |
SBCO |
reponame_str |
Coluna/Columna |
collection |
Coluna/Columna |
repository.name.fl_str_mv |
Coluna/Columna - Sociedade Brasileira de Coluna (SBCO) |
repository.mail.fl_str_mv |
coluna.columna@uol.com.br||revistacoluna@uol.com.br |
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1752126615184211968 |