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Long-term upper extremity performance in children with cerebral palsy following selective dorsal rhizotomy

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Abstract

Purpose

In children with spastic cerebral palsy, selective dorsal rhizotomy (SDR) is conducted to improve lower limb spasticity. Improvements in upper extremity function have also been noted in early follow-up. The purpose of this study was to determine if upper extremity improvements are sustained in the long term.

Methods

A retrospective review of prospectively collected data on children who underwent SDR was conducted. Quality of Upper Extremities Skill Test (QUEST) scores for dissociated movement, grasp and total scores were compared using repeated measures ANOVA for individual patients at three time points: preoperatively, early post-operatively (≤ 2 years) and late post-operatively (9+ years).

Results

Out of 200+ patients having SDR, 32 had QUEST assessment at all three time points. Significant improvements in QUEST dissociated movement (F = 3.665, p = 0.045), grasp (F = 7.995, p = 0.001) and total scores (F = 9.471, p = 0.001) were found. Pairwise comparisons were significant from pre-operative to early post-operative times for all QUEST scores (p = 0.001, 0.003, 0.001), and this was maintained at late post-operative assessment for grasp and total scores (p = 0.02, p = 0.02). There was no significant change in scores between early and late post-operative assessment time points.

Conclusion

Early improvements in upper extremity QUEST total scores are sustained in the long term following SDR.

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Data availability

The anonymized datasets analysed during the current study are available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. Department of Occupational Therapy, British Columbia Children’s Hospital, 4480 Oak Street, Room K3-130, Vancouver, BC, V6H 3V4, Canada

    Patricia Mortenson

  2. Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, Canada

    Patricia Mortenson

  3. Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bengaluru, India

    Nishanth Sadashiva

  4. Division of Pediatric Neurosurgery, Department of Surgery, University of British Columbia and British Columbia Children’s Hospital, Vancouver, Canada

    Mandeep S. Tamber & Paul Steinbok

Authors
  1. Patricia Mortenson
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  2. Nishanth Sadashiva
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  3. Mandeep S. Tamber
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  4. Paul Steinbok
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Contributions

All authors contributed to the study conception and design. Material preparation and data collection were performed by Patricia Mortenson and Paul Steinbok and analyses were performed by Nishanth Sadashiva, Mandeep Tamber and Patricia Mortenson. The first draft of the manuscript was written by Patricia Mortenson and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Patricia Mortenson.

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Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethics approval

The methodology for this study was approved by the Clinical Research Ethics Board of the University of British Columbia (certificate # H17-02783).

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Not applicable (retrospective study).

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What this paper adds

• Improvements in upper extremity movement following SDR are maintained in the long term

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Mortenson, P., Sadashiva, N., Tamber, M.S. et al. Long-term upper extremity performance in children with cerebral palsy following selective dorsal rhizotomy. Childs Nerv Syst 37, 1983–1989 (2021). https://doi.org/10.1007/s00381-020-05018-2

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  • DOI: https://doi.org/10.1007/s00381-020-05018-2

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