Longer-term Results of Lower Limb Surgical Intervention on Gross Motor Function in Cerebral Palsy Patients

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  • NAKADERA Takashi
    Department of Orthopaedic Surgery, West-Shimane rehabilitation center for the disabled children
  • HOSHINO Koutarou
    Department of Orthopaedic Surgery, West-Shimane rehabilitation center for the disabled children
  • KIHARA Kiyoshi
    Department of Orthopaedic Surgery, West-Shimane rehabilitation center for the disabled children

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  • 脳性麻痺に対する下肢観血的治療の粗大運動能力における中期成績
  • ノウセイ マヒ ニ タイスル カシカン ケツテキ チリョウ ノ ソダイ ウンドウ ノウリョク ニ オケル チュウキ セイセキ

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Abstract

Longer-term results of Orthopaedic Selective Spasticity-Control Surgery (OSSCS) on gross motor function in 25 patients with cerebral palsy were investigated and compared to the natural history of 70 non-surgical patients with brain-related disabilities, who were visiting this center, in GML using longitudinal and stratified analysis. Participants were 9 females and 16 males, who had previously undergone OSSCS at 13.1 years (5.3 to 38.9) on the average. There were 8, 2, 3, 5, and 7 patients from level 1 to 5 in the Gross Motor Function Classification System (GMFCS), respectively. Gross Motor Function Measure (GMFM) and Gross Motor Level (GML) were evaluated at pre-operation, one year after surgical intervention and every year thereafter. The average passage observation period was 6.4 years (3.7 to 8.4). A good one year postoperative outcome was obtained in 25 cases (100%) in GML and 23 (92%) in GMFM. Good maintenance was recognized in 22 cases (88%) in GML and 17 cases (68%) in GMFM as observed by postoperative progress. The gross motor function began to deteriorate from around 20 years of age in the no-operation group and experienced a drop for many cases in their late thirties. Even this ages, all of 8 patients of operative group with this ages maintained good results in GML. From these results, we found that OSSCS is an effective surgical intervention and that its effect was maintained for many cerebral palsy cases for the postoperative middle term.

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