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

Full 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; Wilcoxonp<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.

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Author information

Author/s: McLaughlin, John (J); Bjornson, Kristie (K); Temkin, Nancy (N); Steinbok, Paul (P); Wright, Virginia (V); Reiner, Ann (A); Roberts, Theodore (T); Drake, James (J); O'Donnell, Maureen (M); Rosenbaum, Peter (P); Barber, Jason (J); Ferrel, Anne (A);

Affiliation: Children's Hospital and Regional Medical Center, Seattle, WA 98105, USA. jfmcl@u.washington.edu

Grants: R01-NS27867 (Agency:United States NINDS)

Journal and publication information

Publication Type: Comparative Study; Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.

Journal: Developmental medicine and child neurology (Dev Med Child Neurol), published in England. (Language: eng)

Reference: 2002-Jan; vol 44 (issue 1) : pp 17-25

Dates: Created 2002/01/28; Completed 2002/02/05; Revised 2008/05/21;

PMID: 11811645, status: MEDLINE (last retrieval date: 11/6/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

Comments and Corrections

CommentIn: Dev Med Child Neurol. 2008 Apr;50(4):244. (PMID: 18352992)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Cerebral Palsy - surgery
Child
Child, Preschool
Disabled Children
Female
Ganglia, Spinal - surgery

Humans
Male
Motor Skills
Randomized Controlled Trials as Topic
Rhizotomy
Treatment Outcome

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