Multilevel Surgery Improves Outcomes in Cerebral Palsy

Children's functional and dynamic positioning improve, but not grasp-release ability

THURSDAY, April 21 (HealthDay News) -- Functional and dynamic positional outcomes improve in children with hemiplegic cerebral palsy who undergo single-event multilevel surgery, according to a study published in the April 6 issue of The Journal of Bone & Joint Surgery.

J. Adam Smitherman, M.D., from the Greenville Hospital System University Medical Center in South Carolina, and colleagues assessed the functional outcomes, as described by the Shriners Hospital for Children Upper Extremity Evaluation, of 40 children with hemiplegic cerebral palsy who underwent single-event multilevel surgery. The spontaneous functional, dynamic positional, and grasp-release analysis of the children in the study were compared to 26 children with hemiplegic cerebral palsy who did not undergo upper-extremity interventions.

The investigators found that children who underwent single-event multilevel surgery demonstrated significant improvements in the mean spontaneous functional analysis score and the mean dynamic positional analysis score, but not the mean grasp-release analysis score. Significant differences in these scores were seen between the multilevel surgery group and the nonoperative group. No significant changes were seen in the nonoperative group in any of the measures.

"Dynamic joint and limb segment positioning and, to a lesser degree, spontaneous use of the upper extremity in children with hemiplegic cerebral palsy can be significantly improved by single-event multilevel surgery. However, the grasp-release ability did not significantly change in either the operative or nonoperative group," the authors write.

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