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首页> 外文期刊>Gait & posture >Long term outcome of single event multilevel surgery in spastic diplegia with flexed knee gait
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Long term outcome of single event multilevel surgery in spastic diplegia with flexed knee gait

机译：膝关节屈曲性痉挛性截瘫的单项多级手术的长期结果

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Distal hamstring lengthening (DHL) is a commonly performed procedure in flexed knee gait. However, the necessity of this procedure has been challenged due to the concerns on adverse effects in long-term follow-up. This retrospective study was undertaken to investigate the long-term outcome of single event multilevel surgery (SEMLS), including bilateral DHL, in ambulatory patients with cerebral palsy using 3D gait analysis. Twenty-nine ambulatory patients with spastic diplegic cerebral palsy who had undergone SEMLS including bilateral DHL were included. 3D gait analysis was performed preoperatively, 1 year postoperatively and over 10 years postoperatively. Preoperative temporal parameters, kinematics and GDI were compared with values obtained 1 and 10 year follow-up visits. The mean age of patients at time of first surgery was 8.3 years (range, 5.4-16.3 years), and mean time from first surgery to last 3D gait analysis was 11.8 years (range, 10.0-13.3 years). Mean pelvic tilt was not changed significantly after SEMLS including DHL. Mean knee flexion at initial contact decreased from 31.1° preoperatively to 26.0° at 1 year postoperatively (. p=. 0.065), and then decreased significantly to 23.6° at 10 years postoperatively (. p=. 0.038) versus the preoperative value. Mean GDI score significantly improved from 69.4 preoperatively to 77.9 at 1 year postoperatively (. p=. 0.003) and continuously improved to 82.2 at 10 years postoperatively (. p=. 0.017). Single event multilevel surgery including DHL provides a favorable outcome 10 years postoperatively in patients with spastic diplegic cerebral palsy.
机译：远端绳肌延长术（DHL）是屈膝步态中常见的手术方法。然而，由于担心长期随访中的不良反应，该方法的必要性受到了挑战。这项回顾性研究旨在通过3D步态分析研究非活动性脑瘫患者的单事件多级手术（SEMLS）（包括双侧DHL）的长期疗效。包括接受双侧DHL的SEMLS的29名门诊痉挛性双腿瘫痪的门诊患者。术前，术后1年和术后10年进行3D步态分析。将术前的时间参数，运动学和GDI与1年和10年随访时获得的值进行比较。首次手术时患者的平均年龄为8.3岁（范围：5.4-16.3岁），从首次手术到最后的3D步态分析的平均时间为11.8年（范围为10.0-13.3岁）。包括DHL在内的SEMLS术后平均骨盆倾斜度没有明显改变。初次接触时的平均膝关节屈曲度从术前的31.1°降至术后1年的26.0°（。p = 0.065），然后在术后10年显着降低至23.6°（。p = 0.038）。平均GDI评分从术前的69.4显着提高到术后1年的77.9（p = 0.003），并在术后10年持续提高到82.2（p = 0.017）。痉挛性二肢瘫痪性脑瘫患者在术后10年内，包括DHL在内的单项多级手术可获得良好的效果。

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