Electrophysiological monitoring during selective dorsal rhizotomy, and spasticity and GMFM performance

The relation between abnormal electrophysiological responses to intraoperative stimulation during selective dorsal rhizotomy (SDR) and the degree of spasticity and motor dysfunction was explored in 92 children with spastic cerebral palsy (CP) who underwent SDR at a single center. The proportion of a...

Full description

Saved in:
Bibliographic Details
Published in:Developmental medicine and child neurology 1998-04, Vol.40 (4), p.233-238
Main Authors: Hays, Ross M, McLaughlin, John F, Bjornson, Kristie F, Stephens, Kari, Roberts, Theodore S, Price, Robert
Format: Article
Language:English
Subjects:
Adolescent
Adult
Cerebral Palsy - diagnosis
Cerebral Palsy - physiopathology
Cerebral Palsy - surgery
Child
Child, Preschool
Cohort Studies
Electromyography
Electrophysiology
Female
Humans
Male
Monitoring, Intraoperative
Muscle, Skeletal - innervation
Prospective Studies
Rhizotomy - methods
Severity of Illness Index
Spinal Nerve Roots - physiopathology
Spinal Nerve Roots - surgery
Treatment Outcome
Citations: Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:The relation between abnormal electrophysiological responses to intraoperative stimulation during selective dorsal rhizotomy (SDR) and the degree of spasticity and motor dysfunction was explored in 92 children with spastic cerebral palsy (CP) who underwent SDR at a single center. The proportion of abnormally responding rootlets was compared with the degree of spasticity measured with the modified Ash worth Scale (MAS) and with the spasticity measurement system (SMS) at discrete segmental levels. Motor impairment measured with the Gross Motor Function Measure (GMFM) was also compared with the proportion of abnormally responding dorsal rootlets. A consistent relation between the proportion of abnormally responding rootlets and the degree of spasticity and gross motor abnormality at the corresponding muscles could not be demonstrated. There was also no consistent association between the proportion of rootlets ablated during SDR and the change in spasticity measured with the MAS and SMS, or to the change in motor function as measured with the GMFM. These data suggest that the intraoperative monitoring technique most commonly used for SDR is unlikely to identify accurately those neural elements which contribute to spasticity in children with CP.
ISSN:0012-1622
1469-8749
DOI:10.1111/j.1469-8749.1998.tb15455.x