Selective dorsal rhizotomy long-term effects on functional motility in Jordanian children with spastic cerebral palsy
IntroductionSpasticity management in children with cerebral palsy (CP) is a challenge for healthcare providers worldwide. In the US and Europe, treatment options include non-surgical and surgical (i.e., selective dorsal rhizotomy, SDR) procedures, with beneficial effects on functional motility. SDR...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2025-01-01
|
| Series: | Frontiers in Neurology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2025.1502451/full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832582605497696256 |
|---|---|
| author | Yazan E. Al-kharabsheh Anas Said Ismail A. Ismaiel Issam Khawaja Marwan Altaher Ali Bani-Ahmed Carmen M. Cirstea Carmen M. Cirstea |
| author_facet | Yazan E. Al-kharabsheh Anas Said Ismail A. Ismaiel Issam Khawaja Marwan Altaher Ali Bani-Ahmed Carmen M. Cirstea Carmen M. Cirstea |
| author_sort | Yazan E. Al-kharabsheh |
| collection | DOAJ |
| description | IntroductionSpasticity management in children with cerebral palsy (CP) is a challenge for healthcare providers worldwide. In the US and Europe, treatment options include non-surgical and surgical (i.e., selective dorsal rhizotomy, SDR) procedures, with beneficial effects on functional motility. SDR was introduced in Jordan in 2019. We performed the first assessment of the long-term effects on motor function in Jordanian children with spastic CP (SCP) who underwent SDR.MethodsA retrospective cohort study of 43 patients (28 boys, 15 girls, mean ± SD age at surgery, 6.2 ± 2.5 years, 67.4% with diplegia, 30.2% quadriplegia, and 2.3% hemiplegia, 97.7% bilateral deficits) who received SDR (42 bilateral) was conducted between 01/01/2019 and 03/01/2023. Gross Motor Function Classification System (GMFCS) and Functional Mobility Scale (FMS) scores were compared before and 12 months after SDR. Sex, age and clinical scores at surgery, and post-SDR surgical treatment were included in the model (IBM SPSS Statistics 29.0).ResultsClinical scores improved 12 months after SDR: GMFCS decreased by at least one level (in 58.5% of patients), and FMS significantly increased (p < 0.001); GMFCS decreased in 77.7% of those with pre-SDR severe impairment vs. 43.5% in moderately to mildly impaired patients. An age sub-analysis demonstrated higher changes in GMFCS in younger children (GMFCS decreased in 46.9% of those aged <10 years old vs. none in those older than 10 years). These findings suggest that younger children (<10 years old) and more impaired (levels IV and V on GMFCS) are likely the best candidates for this procedure. Twelve-month functional improvement was similar in boys and girls (GMFCS decreased in 44.0% of boys vs. 37.5% of girls). Compared to pre-SDR management, all patients continued physiotherapy, less received Botox (by 97.7%), and more received adjunct orthopedic surgeries (32.6% vs. none) after SDR; out of those receiving post-SDR adjuvant surgeries, 50.0% improved GMFCS (compared to 64.0% of those without).ConclusionOur data demonstrated SDR’s beneficial long-term effects on functional mobility in SCP children, particularly those younger than 10 years and more severely impaired. These findings provide critical information that may aid in identifying “the best” therapeutic window and “the best” candidate for SDR in Jordan. |
| format | Article |
| id | doaj-art-aae89f44f3c24143ae118ccdccfb77fa |
| institution | Kabale University |
| issn | 1664-2295 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj-art-aae89f44f3c24143ae118ccdccfb77fa2025-01-29T14:33:37ZengFrontiers Media S.A.Frontiers in Neurology1664-22952025-01-011610.3389/fneur.2025.15024511502451Selective dorsal rhizotomy long-term effects on functional motility in Jordanian children with spastic cerebral palsyYazan E. Al-kharabsheh0Anas Said1Ismail A. Ismaiel2Issam Khawaja3Marwan Altaher4Ali Bani-Ahmed5Carmen M. Cirstea6Carmen M. Cirstea7University of Missouri School of Medicine, Columbia, MO, United StatesDepartment of Neurosurgery, Al Bashir Hospital, Amman, JordanDepartment of Neurosurgery, Al Bashir Hospital, Amman, JordanDepartment of Neurosurgery, Al Bashir Hospital, Amman, JordanDepartment of Neurosurgery, Al Bashir Hospital, Amman, JordanDepartment of Rehabilitation Sciences, Jordan University of Science and Technology, Irbid, JordanUniversity of Missouri School of Medicine, Columbia, MO, United StatesDepartment of Physical Medicine and Rehabilitation, University of Missouri School of Medicine, Columbia, MO, United StatesIntroductionSpasticity management in children with cerebral palsy (CP) is a challenge for healthcare providers worldwide. In the US and Europe, treatment options include non-surgical and surgical (i.e., selective dorsal rhizotomy, SDR) procedures, with beneficial effects on functional motility. SDR was introduced in Jordan in 2019. We performed the first assessment of the long-term effects on motor function in Jordanian children with spastic CP (SCP) who underwent SDR.MethodsA retrospective cohort study of 43 patients (28 boys, 15 girls, mean ± SD age at surgery, 6.2 ± 2.5 years, 67.4% with diplegia, 30.2% quadriplegia, and 2.3% hemiplegia, 97.7% bilateral deficits) who received SDR (42 bilateral) was conducted between 01/01/2019 and 03/01/2023. Gross Motor Function Classification System (GMFCS) and Functional Mobility Scale (FMS) scores were compared before and 12 months after SDR. Sex, age and clinical scores at surgery, and post-SDR surgical treatment were included in the model (IBM SPSS Statistics 29.0).ResultsClinical scores improved 12 months after SDR: GMFCS decreased by at least one level (in 58.5% of patients), and FMS significantly increased (p < 0.001); GMFCS decreased in 77.7% of those with pre-SDR severe impairment vs. 43.5% in moderately to mildly impaired patients. An age sub-analysis demonstrated higher changes in GMFCS in younger children (GMFCS decreased in 46.9% of those aged <10 years old vs. none in those older than 10 years). These findings suggest that younger children (<10 years old) and more impaired (levels IV and V on GMFCS) are likely the best candidates for this procedure. Twelve-month functional improvement was similar in boys and girls (GMFCS decreased in 44.0% of boys vs. 37.5% of girls). Compared to pre-SDR management, all patients continued physiotherapy, less received Botox (by 97.7%), and more received adjunct orthopedic surgeries (32.6% vs. none) after SDR; out of those receiving post-SDR adjuvant surgeries, 50.0% improved GMFCS (compared to 64.0% of those without).ConclusionOur data demonstrated SDR’s beneficial long-term effects on functional mobility in SCP children, particularly those younger than 10 years and more severely impaired. These findings provide critical information that may aid in identifying “the best” therapeutic window and “the best” candidate for SDR in Jordan.https://www.frontiersin.org/articles/10.3389/fneur.2025.1502451/fullspastic cerebral palsyselective dorsal rhizotomyJordanfunctional mobilitychildren |
| spellingShingle | Yazan E. Al-kharabsheh Anas Said Ismail A. Ismaiel Issam Khawaja Marwan Altaher Ali Bani-Ahmed Carmen M. Cirstea Carmen M. Cirstea Selective dorsal rhizotomy long-term effects on functional motility in Jordanian children with spastic cerebral palsy Frontiers in Neurology spastic cerebral palsy selective dorsal rhizotomy Jordan functional mobility children |
| title | Selective dorsal rhizotomy long-term effects on functional motility in Jordanian children with spastic cerebral palsy |
| title_full | Selective dorsal rhizotomy long-term effects on functional motility in Jordanian children with spastic cerebral palsy |
| title_fullStr | Selective dorsal rhizotomy long-term effects on functional motility in Jordanian children with spastic cerebral palsy |
| title_full_unstemmed | Selective dorsal rhizotomy long-term effects on functional motility in Jordanian children with spastic cerebral palsy |
| title_short | Selective dorsal rhizotomy long-term effects on functional motility in Jordanian children with spastic cerebral palsy |
| title_sort | selective dorsal rhizotomy long term effects on functional motility in jordanian children with spastic cerebral palsy |
| topic | spastic cerebral palsy selective dorsal rhizotomy Jordan functional mobility children |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2025.1502451/full |
| work_keys_str_mv | AT yazanealkharabsheh selectivedorsalrhizotomylongtermeffectsonfunctionalmotilityinjordanianchildrenwithspasticcerebralpalsy AT anassaid selectivedorsalrhizotomylongtermeffectsonfunctionalmotilityinjordanianchildrenwithspasticcerebralpalsy AT ismailaismaiel selectivedorsalrhizotomylongtermeffectsonfunctionalmotilityinjordanianchildrenwithspasticcerebralpalsy AT issamkhawaja selectivedorsalrhizotomylongtermeffectsonfunctionalmotilityinjordanianchildrenwithspasticcerebralpalsy AT marwanaltaher selectivedorsalrhizotomylongtermeffectsonfunctionalmotilityinjordanianchildrenwithspasticcerebralpalsy AT alibaniahmed selectivedorsalrhizotomylongtermeffectsonfunctionalmotilityinjordanianchildrenwithspasticcerebralpalsy AT carmenmcirstea selectivedorsalrhizotomylongtermeffectsonfunctionalmotilityinjordanianchildrenwithspasticcerebralpalsy AT carmenmcirstea selectivedorsalrhizotomylongtermeffectsonfunctionalmotilityinjordanianchildrenwithspasticcerebralpalsy |