Top

Child's Nervous System

Published in:

01-09-2020 | Rhizotomy | Focus Session

Quality of life after selective dorsal rhizotomy: an assessment of family-reported outcomes using the CPQoL questionnaire

Authors: James M. W. Robins, Abbey Boyle, Kate McCune, Rajib Lodh, John R. Goodden

Published in: Child's Nervous System | Issue 9/2020

Abstract

Background

Selective dorsal rhizotomy (SDR) is widely accepted as an effective procedure for management of lower limb spasticity in children with cerebral palsy. However, effects of the procedure on quality of life are not widely reported and less so using a structured and validated quality of life tool such as Cerebral Palsy Quality of Life Questionnaire (CPQoL). Here, we present complete data for CPQoL outcomes for SDR patients operated in a single institution at 2 years follow-up.

Methods

Patients were operated over a 5-year period by the same surgeon using the same technique in a single institution. CPQoL questionnaires were completed by patients and families pre-operatively and at 6 months, 1 year and 2 years post-operatively. Data was collected prospectively.

Results

A total of 78 patients (58 male, 20 female), age range 2.6–13.8 years (median 6.33) were included whom underwent SDR between October 2012–November 2017. All had complete follow-up up to 2 years post-procedure (most recent November 2019). Four patients were excluded due to incomplete follow-up data. Statistically significant improvement was seen across five out of seven CPQoL domains and this was sustained to 2 years post-SDR.

Conclusions

We demonstrate using a validated Quality of Life Tool that SDR has a beneficial effect on the quality of life for patients with cerebral palsy at this length of follow-up.

Ross SA, Engsberg JR (2007) Relationships between spasticity, strength, gait, and the GMFM-66 in persons with spastic diplegia cerebral palsy. Arch Phys Med Rehabil 88:1114–1120. https://doi.org/10.1016/j.apmr.2007.06.011CrossRefPubMed

Chen KL, Wang HY, Tseng MH, Shieh JY, Lu L, Yao KPG, Huang CY (2013) The cerebral palsy quality of life for children (CP QOL-child): evidence of construct validity. Res Dev Disabil 34:994–1000. https://doi.org/10.1016/j.ridd.2012.11.025CrossRefPubMed

Steinbok P (2007) Selective dorsal rhizotomy for spastic cerebral palsy: a review. Childs Nerv Syst 23:981–990. https://doi.org/10.1007/s00381-007-0379-5CrossRefPubMed

Sherrington CS (1898) Decerebrate rigidity, and reflex coordination of movements. J Physiol 22:319–332. https://doi.org/10.1113/jphysiol.1898.sp000697CrossRefPubMedPubMedCentral

Sherrington CS (1893) Further experimental note on the correlation of action of antagonistic muscles. Br Med J 1:1218. https://doi.org/10.1136/bmj.1.1693.1218CrossRefPubMedPubMedCentral

Sindou M (2003) Dorsal rhizotomies in children. Neurochirurgie 49:312–323PubMed

Gros C, Ouaknine G, Vlahovitch B, Frèrebeau P (1967) Selective posterior radicotomy in the neurosurgical treatment of pyramidal hypertension. Neurochirurgie 13(4)505–518

Fasano VA, Broggi G, Barolat-Roman G, Sguazzi A (1978) Surgical treatment of spasticity in cerebral palsy. Pediatr Neurosurg 4:289–305. https://doi.org/10.1159/000119785CrossRef

Peacock WJ, Arens LJ (1982) Selective posterior rhizotomy for the relief of spasticity in cerebral palsy. S Afr Med J 62:119–124PubMed

10.

Peter JC, Hoffman EB, Arens LJ, Peacock WJ (1990) Incidence of spinal deformity in children after multiple level laminectomy for selective posterior rhizotomy. Childs Nerv Syst 6:30–32. https://doi.org/10.1007/BF00262263CrossRefPubMed

11.

Langerak NG, Vaughan CL, Hoffman EB, Figaji AA, Fieggen AG, Peter JC (2009) Incidence of spinal abnormalities in patients with spastic diplegia 17 to 26 years after selective dorsal rhizotomy. Childs Nerv Syst 25:1593–1603. https://doi.org/10.1007/s00381-009-0993-5CrossRefPubMed

12.

Steinbok P, Hicdonmez T, Sawatzky B, Beauchamp R, Wickenheiser D (2005) Spinal deformities after selective dorsal rhizotomy for spastic cerebral palsy. J Neurosurg Pediatr 102:363–373. https://doi.org/10.3171/ped.2005.102.4.0363CrossRef

13.

Golan JD, Hall JA, O’Gorman G et al (2007) Spinal deformities following selective dorsal rhizotomy. J Neurosurg 106:441–449. https://doi.org/10.3171/ped.2007.106.6.441CrossRefPubMed

14.

Spiegel D, Loder R, Alley K, Rowley S, Gutknecht S, Smith-Wright DL, Dunn ME (2004) Spinal deformity following selective dorsal rhizotomy. J Pediatr Orthop 24:30–36. https://doi.org/10.1097/00004694-200401000-00007CrossRefPubMed

15.

Park TS, Gaffney PE, Kaufman BA, Molleston MC (1993) Selective lumbosacral dorsal rhizotomy immediately caudal to the conus medullaris for cerebral palsy spasticity. Neurosurgery 33:929–934. https://doi.org/10.1227/00006123-199311000-00026CrossRefPubMed

16.

Steinbok P (2001) Outcomes after selective dorsal rhizotomy for spastic cerebral palsy. Childs Nerv Syst 17:1–18CrossRefPubMed

17.

Josenby AL, Wagner P, Jarnlo G-B, Westbom L, Nordmark E (2012) Motor function after selective dorsal rhizotomy: a 10-year practice-based follow-up study. Dev Med Child Neurol 54:429–435. https://doi.org/10.1111/j.1469-8749.2012.04258.xCrossRefPubMed

18.

Dudley RWR, Parolin M, Gagnon B, Saluja R, Yap R, Montpetit K, Ruck J, Poulin C, Cantin MA, Benaroch TE, Farmer JP (2013) Long-term functional benefits of selective dorsal rhizotomy for spastic cerebral palsy: clinical article. J Neurosurg Pediatr 12:142–150. https://doi.org/10.3171/2013.4.PEDS12539CrossRefPubMed

19.

McLaughlin J, Bjornson K, Temkin N, Steinbok P, Wright V, Reiner A, Roberts T, Drake J, O'Donnell M, Rosenbaum P, Barber J, Ferrel A (2002) Selective dorsal rhizotomy: meta-analysis of three randomized controlled trials. Dev Med Child Neurol 44:17–25. https://doi.org/10.1017/s0012162201001608CrossRefPubMed

20.

Steinbok P (2011) 10-year follow-up after selective dorsal rhizotomy in cerebral palsy. Dev Med Child Neurol 53:678. https://doi.org/10.1111/j.1469-8749.2011.03991.xCrossRefPubMed

21.

Tedroff K, Löwing K, Jacobson DNO, Åström E (2011) Does loss of spasticity matter? A 10-year follow-up after selective dorsal rhizotomy in cerebral palsy. Dev Med Child Neurol 53:724–729. https://doi.org/10.1111/j.1469-8749.2011.03969.xCrossRefPubMed

22.

Tedroff K, Löwing K, Åström E (2015) A prospective cohort study investigating gross motor function, pain, and health-related quality of life 17 years after selective dorsal rhizotomy in cerebral palsy. Dev Med Child Neurol 57:484–490. https://doi.org/10.1111/dmcn.12665CrossRefPubMed

23.

Ailon T, Beauchamp R, Miller S, Mortenson P, Kerr JM, Hengel AR, Steinbok P (2015) Long-term outcome after selective dorsal rhizotomy in children with spastic cerebral palsy. Childs Nerv Syst 31:415–423. https://doi.org/10.1007/s00381-015-2614-9CrossRefPubMed

24.

Arens LJ, Peacock WJ, Peter J (1989) Selective posterior rhizotomy: a long-term follow-up study. Childs Nerv Syst 5:148–152. https://doi.org/10.1007/BF00272116CrossRefPubMed

25.

Mittal S, Farmer JP, Al-Atassi B et al (2002) Long-term functional outcome after selective posterior rhizotomy. J Neurosurg 97:315–325. https://doi.org/10.3171/jns.2002.97.2.0315CrossRefPubMed

26.

Nordmark E, Josenby AL, Lagergren J, Andersson G, Strömblad LG, Westbom L (2008) Long-term outcomes five years after selective dorsal rhizotomy. BMC Pediatr 8:54. https://doi.org/10.1186/1471-2431-8-54CrossRefPubMedPubMedCentral

27.

van Schie PEM, Schothorst M, Dallmeijer AJ, Vermeulen RJ, van Ouwerkerk W, Strijers RL, Becher JG (2011) Short- and long-term effects of selective dorsal rhizotomy on gross motor function in ambulatory children with spastic diplegia. J Neurosurg Pediatr 7:557–562. https://doi.org/10.3171/2011.2.PEDS10452CrossRefPubMed

28.

Park TS (2000) Selective dorsal rhizotomy: an excellent therapeutic option for spastic cerebral palsy. Clin Neurosurg 47:422–439PubMed

29.

Langerak NG, Lamberts RP, Fieggen AG, Peter JC, van der Merwe L, Peacock WJ, Vaughan CL (2008) A prospective gait analysis study in patients with diplegic cerebral palsy 20 years after selective dorsal rhizotomy. J Neurosurg Pediatr 1:180–186. https://doi.org/10.3171/PED/2008/1/3/180CrossRefPubMed

30.

O’Brien DF, Park TS, Puglisi JA et al (2004) Effect of selective dorsal rhizotomy on need for orthopedic surgery for spastic quadriplegic cerebral palsy: long-term outcome analysis in relation to age. J Neurosurg 101:59–63. https://doi.org/10.3171/ped.2004.101.2.0059CrossRefPubMed

31.

Hurvitz EA, Marciniak CM, Daunter AK et al (2013) Functional outcomes of childhood dorsal rhizotomy in adults and adolescents with cerebral palsy. J Neurosurg Pediatr 11:380–388. https://doi.org/10.3171/2013.1.PEDS12311CrossRefPubMed

32.

Park TS, Liu JL, Edwards C et al (2017) Functional outcomes of childhood selective dorsal rhizotomy 20 to 28 years later. Cureus 9:e1256. https://doi.org/10.7759/cureus.1256CrossRefPubMedPubMedCentral

33.

Engsberg JR, Olree KS, Ross SA, Park TS (2008) Spasticity and strength changes as a function of selective dorsal rhizotomy. Neurosurg Focus 4:E9. https://doi.org/10.3171/foc.1998.4.1.10CrossRef

34.

Chan SHS, Yam KY, Yiu-Lau BPH et al (2008) Selective dorsal rhizotomy in Hong Kong: multidimensional outcome measures. Pediatr Neurol 39:22–32. https://doi.org/10.1016/j.pediatrneurol.2008.03.017CrossRefPubMed

35.

Carlon S, Shields N, Yong K, Gilmore R, Sakzewski L, Boyd R (2010) A systematic review of the psychometric properties of quality of life measures for school aged children with cerebral palsy. BMC Pediatr 10:81–11. https://doi.org/10.1186/1471-2431-10-81CrossRefPubMedPubMedCentral

36.

Summers J, Coker B, Eddy S et al (2019) Selective dorsal rhizotomy in ambulant children with cerebral palsy: an observational cohort study. Lancet Child Adolesc Heal 3:455–462. https://doi.org/10.1016/S2352-4642(19)30119-1CrossRef

37.

Waters E, Davis E, Mackinnon A, Boyd R, Graham HK, Kai Lo S, Wolfe R, Stevenson R, Bjornson K, Blair E, Hoare P, Ravens-Sieberer U, Reddihough D (2007) Psychometric properties of the quality of life questionnaire for children with CP. Dev Med Child Neurol 49:49–55. https://doi.org/10.1017/S0012162207000126.xCrossRefPubMed

38.

WHOQOL Group (1993) Study protocol for the World Health Organization project to develop a Quality of Life assessment instrument (WHOQOL). Qual Life Res 2:153–159. https://doi.org/10.1007/BF00435734

39.

Davis E, Mackinnon A, Davern M, Boyd R, Bohanna I, Waters E, Graham HK, Reid S, Reddihough D (2013) Description and psychometric properties of the CP QOL-teen: a quality of life questionnaire for adolescents with cerebral palsy. Res Dev Disabil 34:344–352. https://doi.org/10.1016/j.ridd.2012.08.018CrossRefPubMed

40.

Davis E, Waters E, Shelly A, Gold L (2008) Children and adolescents, measuring the quality of, in international encyclopaedia of public health. Elsevier, London

41.

Davis E, Shelly A, Waters E, Davern M (2010) Measuring the quality of life of children with cerebral palsy: comparing the conceptual differences and psychometric properties of three instruments. Dev Med Child Neurol 52:174–180. https://doi.org/10.1111/j.1469-8749.2009.03382.xCrossRefPubMed

42.

Parkinson KN, Rice H, Young B (2011) Incorporating children's and their parents' perspectives into condition-specific quality-of-life instruments for children with cerebral palsy: a qualitative study. Value Health 14(5):705–711

43.

Waters E, Davis E, Ronen GM, Rosenbaum P, Livingston M, Saigal S (2009) Quality of life instruments for children and adolescents with neurodisabilities: how to choose the appropriate instrument. Dev Med Child Neurol 51:660–669. https://doi.org/10.1111/j.1469-8749.2009.03324.xCrossRefPubMed

44.

Colver A, Rapp M, Eisemann N et al (2015) Self-reported quality of life of adolescents with cerebral palsy: a cross-sectional and longitudinal analysis. Lancet 385:705–716. https://doi.org/10.1016/S0140-6736(14)61229-0CrossRefPubMedPubMedCentral

45.

Arnaud C, White-Koning M, Michelsen SI, Parkes J, Parkinson K, Thyen U, Beckung E, Dickinson HO, Fauconnier J, Marcelli M, McManus V, Colver A (2008) Parent-reported quality of life of children with cerebral palsy in Europe. Pediatrics 121:54–64. https://doi.org/10.1542/peds.2007-0854CrossRefPubMed

Title: Quality of life after selective dorsal rhizotomy: an assessment of family-reported outcomes using the CPQoL questionnaire
Authors: James M. W. Robins
Abbey Boyle
Kate McCune
Rajib Lodh
John R. Goodden
Publication date: 01-09-2020
Publisher: Springer Berlin Heidelberg
Keyword: Rhizotomy
Published in: Child's Nervous System / Issue 9/2020
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI: https://doi.org/10.1007/s00381-020-04546-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Quality of life after selective dorsal rhizotomy: an assessment of family-reported outcomes using the CPQoL questionnaire

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 9/2020

Cerebellar tumour-like aggregate of glycosaminoglycans in a MPS IIIB patient: a case report

Seizures in self-limited epilepsy with centrotemporal spikes: video-EEG documentation

Identification of novel mutations in TSC1 and TSC2 for tuberous sclerosis complex by targeted next-generation sequencing and ACMG guidelines

Frequency distribution in intraoperative stimulation-evoked EMG responses during selective dorsal rhizotomy in children with cerebral palsy—part 2: gender differences and left-biased asymmetry

Frequency distribution in intraoperative stimulation-evoked EMG responses during selective dorsal rhizotomy in children with cerebral palsy—part 1: clinical setting and neurophysiological procedure

Correction to: Combined microsurgical fluorescence for optimizing resection in refractory empyema and cerebritis