Orthopedic surgery after selective dorsal rhizotomy for spastic diplegia in relation to ambulatory status and age

Donncha F. O'Brien, Sung Park Tae, Joan A. Puglisi, David R. Collins, Eric C. Leuthardt, Jeffrey R. Leonard

Research output: Contribution to journalArticle

14 Scopus citations


Object. A retrospective study was performed to determine the following: 1) whether children who walk independently after selective dorsal rhizotomy (SDR) undergo fewer subsequent orthopedic operations than those who walk with assistance; and 2) the effect of age at SDR on the rate of orthopedic operations. Methods. The cases of 158 children with spastic diplegia who were 2 to 14 years of age when they underwent SDR were followed over a 5- to 9-year period. Patients were grouped by age at the time of SDR as follows: 2 to 3 years (Group 1), 4 to 7 years (Group 2), and 8 to 14 years (Group 3). Follow-up data showed that children in all age groups who walked independently after SDR underwent fewer orthopedic operations than did children who walked with assistance. Overall rates of orthopedic surgery 5 to 9 years after SDR at last follow up were 24% for independent walkers and 51% for assisted walkers. Two-way categorical analysis (age group by ambulation) yielded a highly significant effect of ambulation (p = 0.0003). Children in Group 1 needed the fewest orthopedic operations at follow-up evaluation. In the older age groups (Groups 2 and 3), those who walked independently at the time of SDR underwent fewer orthopedic operations after SDR than did walkers who required assistance (p = 0.01). Conclusions. These data are of value in advising parents about the likelihood of orthopedic surgery based on the child's gait status both at the time of SDR and at follow-up evaluation. Orthopedic surgery is more likely in patients destined to be nonambulators.

Original languageEnglish
Pages (from-to)5-9
Number of pages5
JournalJournal of neurosurgery
Issue numberSUPPL. 1
StatePublished - Jul 1 2005


  • Ambulatory status
  • Orthopedic surgery
  • Outcome
  • Pediatric neurosurgery
  • Selective dorsal rhizotomy
  • Spastic diplegia

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