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Child's Nervous System
Published in: Child's Nervous System 2/2010

Open Access 01-02-2010 | Original Paper

Preoperative MRI findings and functional outcome after selective dorsal rhizotomy in children with bilateral spasticity

Authors: Sebastian Grunt, Jules G. Becher, Petra van Schie, Willem J. R. van Ouwerkerk, Mazarin Ahmadi, R. Jeroen Vermeulen

Published in: Child's Nervous System | Issue 2/2010

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Abstract

Purpose

To identify MRI characteristics that may predict the functional effect of selective dorsal rhizotomy (SDR) in children with bilateral spastic paresis.

Methods

We performed SDR in a group of 36 patients. The gross motor functioning measure-66 (GMFM-66) was applied before and after SDR. Available cerebral MRIs were retrospectively classified into three diagnostic groups: periventricular leucomalacia (PVL; n = 10), hydrocephalus (n = 2), and normal (n = 6). In patients with PVL, we scored the severity of the MR abnormalities. We compared the changes in the GMFM-66 after SDR in the diagnostic groups. In patients with PVL, we correlated the severity of the MR abnormalities with the changes in the GMFM-66.

Results

The mean follow-up period was 5 years and 4 months (range, 1 year and 1 month to 9 years). The best improvement in gross motor function was observed in patients with normal MRI, and the slightest improvement was observed in patients with hydrocephalus. The severity of the PVL did correlate with the GMFM-66 score before SDR but not with the functional effect of SDR.

Conclusion

We conclude that with respect to gross motor skills, the improvements after SDR are good in patients with no MRI abnormalities. In the patients with hydrocephalus, the improvements after SDR were insignificant. In patients with PVL, the improvements were intermediate and did not correlate with the degree of PVL.
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Metadata
Title
Preoperative MRI findings and functional outcome after selective dorsal rhizotomy in children with bilateral spasticity
Authors
Sebastian Grunt
Jules G. Becher
Petra van Schie
Willem J. R. van Ouwerkerk
Mazarin Ahmadi
R. Jeroen Vermeulen
Publication date
01-02-2010
Publisher
Springer-Verlag
Published in
Child's Nervous System / Issue 2/2010
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI
https://doi.org/10.1007/s00381-009-0999-z

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