Hostname: page-component-745bb68f8f-b6zl4 Total loading time: 0 Render date: 2025-01-19T05:20:14.129Z Has data issue: false hasContentIssue false
  • English
  • Français

Selective dorsal rhizotomy: meta-analysis of three randomized controlled trials

Published online by Cambridge University Press:  24 January 2002

John McLaughlin ,
Kristie Bjornson ,
Nancy Temkin ,
Paul Steinbok ,
Virginia Wright ,
Ann Reiner ,
Theodore Roberts ,
James Drake ,
Maureen O'Donnell  and
Peter Rosenbaum
...Show all authors
John McLaughlin
Affiliation:
Children's Hospital and Regional Medical Center, Seattle, WA, USA.
Kristie Bjornson
Affiliation:
Children's Hospital and Regional Medical Center, Seattle, WA, USA.
Nancy Temkin
Affiliation:
Children's Hospital and Regional Medical Center, Seattle, WA, USA.
Paul Steinbok
Affiliation:
Children's and Women's Health Centre, Vancouver, BC, USA.
Virginia Wright
Affiliation:
Bloorview MacMillan Centre, Toronto, ON, Canada.
Ann Reiner
Affiliation:
Children's and Women's Health Centre, Vancouver, BC, USA.
Theodore Roberts
Affiliation:
Children's Hospital and Regional Medical Center, Seattle, WA, USA.
James Drake
Affiliation:
Hospital for Sick Children, Toronto, ON, Canada.
Maureen O'Donnell
Affiliation:
Children's and Women's Health Centre, Vancouver, BC, USA.
Peter Rosenbaum
Affiliation:
Bloorview MacMillan Centre, Toronto, ON, Canada.
Jason Barber
Affiliation:
University of Washington, USA.
Anne Ferrel
Affiliation:
Children's Hospital and Regional Medical Center, Seattle, WA, USA.
Get access

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; Wilcoxon p<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.

Type
Original Articles
Information
Developmental Medicine and Child Neurology , Volume 44 , Issue 1 , January 2002 , pp. 17 - 25
Copyright
© 2002 Mac Keith Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)