Selection criteria for selective dorsal rhizotomy in children with spastic cerebral palsy: a systematic review of the literature. (24th September 2013)

• Record Type: Journal Article
• Authors: Grunt, Sebastian; Fieggen, A Graham; Vermeulen, R Jeroen; Becher, Jules G; Langerak, Nelleke G
• Is Part Of: Developmental medicine & child neurology. Volume 56:Number 4(2014:Apr.)
• Page Start: 302
• Page End: 312
• Publication Date: 2013-09-24
• Subjects: Child development -- Periodicals; Pediatric neurology -- Periodicals; 616.8
• DOI: 10.1111/dmcn.12277
• Languages: English
• ISSNs: 0012-1622

Abstract

<abstract abstract-type="main" id="dmcn12277-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="dmcn12277-sec-0001" sec-type="section"> <title>Aim</title> <p>Information regarding the selection procedure for selective dorsal rhizotomy (SDR) in children with spastic cerebral palsy (CP) is scarce. Therefore, the aim of this study was to summarize the selection criteria for SDR in children with spastic CP.</p> </sec> <sec id="dmcn12277-sec-0002" sec-type="section"> <title>Method</title> <p>A systematic review was carried out using the following databases: MEDLINE, CINAHL, EMBASE, PEDro, and the Cochrane Library. Additional studies were identified in the reference lists. Search terms included 'selective dorsal rhizotomy', 'functional posterior rhizotomy', 'selective posterior rhizotomy', and 'cerebral palsy'. Studies were selected if they studied mainly children (<18y of age) with spastic CP, if they had an intervention of SDR, if they had a detailed description of the selection criteria, and if they were in English. The levels of evidence, conduct of studies, and selection criteria for SDR were scored.</p> </sec> <sec id="dmcn12277-sec-0003" sec-type="section"> <title>Results</title> <p>Fifty‐two studies were included. Selection criteria were reported in 16 International Classification of Functioning, Disability and Health model domains including 'body structure and function' (details concerning spasticity [94%], other movement abnormalities [62%], and strength [54%]), 'activity' (gross motor function [27%]), and 'personal and environmental factors' (age [44%], diagnosis [50%], motivation [31%], previous surgery [21%], and follow‐up therapy [31%]). Most selection criteria were not based on standardized measurements.</p> </sec> <sec id="dmcn12277-sec-0004" sec-type="section"> <title>Interpretation</title> <p>Selection criteria for SDR vary considerably. Future studies should describe clearly the selection procedure. International meetings of experts should develop more uniform consensus guidelines, which could form the basis for selecting candidates for SDR.</p> </sec> </abstract>