Single event multilevel surgery in spastic patient : A Hospital Tengku Ampuan Afzan (HTAA) experience
INTRODUCTION: Single event multilevel surgery (SEMLS) is common procedure to improve gait and functioning of children with spastic cerebral palsy (CP).The case series is aim to observe the post-operative outcomes of gross motor function (GMFCS) and hip migration index (MI) in spastic patient....
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Malaysian Orthopaedic Association (MOA)
2019
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| Online Access: | http://irep.iium.edu.my/74790/ http://irep.iium.edu.my/74790/ http://irep.iium.edu.my/74790/18/74790%20Single%20Event%20Multilevel%20Surgery.pdf |
| Summary: | INTRODUCTION:
Single event multilevel surgery (SEMLS) is common procedure to improve gait and functioning of children with spastic cerebral palsy (CP).The case series is aim to observe the post-operative outcomes of gross motor function (GMFCS) and hip migration index (MI) in spastic patient.
MATERIALS & METHODS:
Patient underwent SEMLS at HTAA from 2014 to 2018. The data were data taken from case notes during follow-up at rehabilitation clinic.
RESULTS:
There were 10 patients, 6 were boys.Mean age at surgery was 6.6 years old. 7 having spastic diplegic CP and 1 each having triplegic and quadriplegic CP. 4 patients were in GMFCS IV before surgery, 3 had GMFCS III, 2 in GMFCS II and 1 in GMFCS V. 2 patients had second surgery at 1 year apart:1 underwent talipes equinovarus deformity correction and another had repeated SEMLS. Only 5 patients had pre and post-operative pelvis radiograph where 4 patients (80%) improved in hip MI. 40% of patient have 1 level improvement. 75% of patients with GMFCS IV had improvement compared to GMFCS III (33%).
DISCUSSIONS:
73.5% has good improvement of hip MI postoperatively with 0.3% risk of hip surgery1. Incidence of hip displacement related to GMFCS level2.Evidence proved that SEMLS improved gait3 and stability of GMFCS4.
CONCLUSION:
SEMLS may affect the improvement and stability of GMFCS level and hip MI; and that effect may be level-dependent. |
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