Selective dorsal rhizotomy: meta-analysis of three randomized controlled trials Academic Article uri icon

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abstract

  • This study is a comparative analysis and meta-analysis of three randomized clinical trials. Children with spastic diplegia received either 'selective' dorsal rhizotomy (SDR) plus physiotherapy (SDR+PT) or PT without SDR (PT-only). Common outcome measures were used for spasticity (Ashworth scale) and function (Gross Motor Function Measure [GMFM]). Baseline and 9- to 12-month outcome data were pooled (n=90). At baseline, 82 children were under 8 years old and 65 had Gross Motor Function Classification System level II or III disability. Pooled Ashworth data analysis confirmed a reduction of spasticity with SDR+PT (mean change score difference -1.2; Wilcoxonp<0.001). Pooled GMFM data revealed greater functional improvement with SDR+PT (difference in change score +4.0, p=0.008). Multivariate analysis in the SDR+PT group revealed a direct relationship between percentage of dorsal root tissue transected and functional improvement. SDR+PT is efficacious in reducing spasticity in children with spastic diplegia and has a small positive effect on gross motor function.

authors

  • McLaughlin, John
  • Bjornson, Kristie
  • Temkin, Nancy
  • Steinbok, Paul
  • Wright, Virginia
  • Reiner, Ann
  • Roberts, Theodore
  • Drake, James
  • O'Donnell, Maureen
  • Rosenbaum, Peter Leon
  • Barber, Jason
  • Ferrel, Anne

publication date

  • January 2002