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首页> 外文期刊>Gait & posture >Changes in gait which occur before and during the adolescent growth spurt in children treated by selective dorsal rhizotomy
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Changes in gait which occur before and during the adolescent growth spurt in children treated by selective dorsal rhizotomy

机译：选择性背脊神经切断术治疗的儿童青春期突增前后步态变化

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This paper presents long term follow up results from 17 children (6 girls, 11 boys, GMFCS levels II-IV), treated by means of selective dorsal rhizotomy (SDR). The particular focus is on the effect of the adolescent growth spurt on patients who had previously undergone SDR. The children were all assessed using 3D gait analysis, in combination with clinical examination at three time points before SDR surgery (PRE), after SDR surgery when pre-adolescent (POST) and post-adolescence (POST2). The total follow up period to POST2 was 8 years 6 months for girls and 9 years 5 months for boys. All children maintained or improved their GMFCS level. Positive changes in ranges of motion and gait were observed at POST1 and these were generally maintained over adolescence to POST2. The mean Gait Profile Score (GPS) had improved by 3.2 points (14.7-11.5) at POST1, with a non-significant deterioration of 0.3 over the adolescent growth spurt. These positive results reflect the total package of care for the children, involving careful pre-operative selection by a multidisciplinary team and post-operative management including intensive physiotherapy and maintenance in tuned ankle foot orthoses. Fifty-nine per cent of children had some additional orthopaedic surgery, mostly bony procedures. The overall benefits arising from their management need to be considered in the light of the likely deterioration experienced by this patient group. The results of this study support the use of SDR as part of a management strategy for carefully selected children with cerebral palsy with the aim of optimizing gait at skeletal maturity. (C) 2015 Elsevier B.V. All rights reserved.
机译：本文介绍了17例儿童（6例女孩，11例男孩，GMFCS II-IV级）的长期随访结果，采用选择性背脊神经切断术（SDR）治疗。特别关注青少年成长突增对以前接受过SDR的患者的影响。在SDR手术前（PRE），青春期前（POST）和青春期后（POST2）的三个时间点，均使用3D步态分析结合临床检查对儿童进行了评估。 POST2的总随访期为女孩8年6个月，男孩9年5个月。所有儿童均保持或改善了他们的GMFCS水平。在POST1处观察到运动和步态范围的积极变化，这些变化通常在青春期到POST2时得以维持。 POST1的平均步态分布评分（GPS）提高了3.2点（14.7-11.5），与青少年增长突增相比无显着恶化0.3。这些积极的结果反映了对儿童的总体护理方案，包括多学科团队对术前的仔细选择以及包括强化物理治疗和脚踝矫形器维持在内的术后管理。 59％的儿童接受了其他骨科手术，大部分是骨性手术。应根据该患者群体可能恶化的情况考虑其管理产生的总体益处。这项研究的结果支持使用SDR作为精心挑选的脑瘫患儿管理策略的一部分，目的是优化步态的骨骼成熟度。 （C）2015 Elsevier B.V.保留所有权利。

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