Selective dorsal rhizotomy after baclofen intrathecal pump removal: a single-center experience and review of the literature.

IF 1.3 4区医学 Q4 CLINICAL NEUROLOGY

Child's Nervous System Pub Date : 2024-12-01 Epub Date: 2024-09-24 DOI:10.1007/s00381-024-06618-y

Claudio Ruggiero, Massimiliano Porzio, Francesco Tengattini, Giuseppe Cinalli, Pietro Spennato

{"title":"Selective dorsal rhizotomy after baclofen intrathecal pump removal: a single-center experience and review of the literature.","authors":"Claudio Ruggiero, Massimiliano Porzio, Francesco Tengattini, Giuseppe Cinalli, Pietro Spennato","doi":"10.1007/s00381-024-06618-y","DOIUrl":null,"url":null,"abstract":"Purpose: Selective dorsal rhizotomy (SDR) and intrathecal baclofen (ITB) pump placement are two surgical options in children affected by spasticity secondary to cerebral palsy 1. The latest literature is an enlarging indication for SDR in case of ITB failure in non-ambulant patients as an alternative to pump reimplantation to reduce spasticity and facilitate patients' care.Methods: A retrospective single-center study has screened all children diagnosed with spastic tetraparesis who underwent in the last 10 years SDR and had previously ITB pump implanted. A cohort of six patients was pooled out. Furthermore, pertinent literature has been reviewed.Results: Indication for pump removal was pump pocket infection, parents' decision, and poor response to ITB. Patients' amount of lifetime with the pump implanted has been 6.9 years. The preoperative and postoperative Ashworth scores were statistically different in both procedures (p = 0.005 and p = 0.,02).Conclusions: Only two studies investigated the pediatric population undergoing SDR in the occurrence of ITB pump removal. Authors are offering SDR to all children, regardless of GMFCS groups and previous ITB pump placement. In conclusion, SDR represents a valid tool in neurosurgeon's hands to help ameliorate patients' long-lasting quality of life, reducing the severity of the spasticity and leading to better management by caregivers.","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":" ","pages":"4089-4094"},"PeriodicalIF":1.3000,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Child's Nervous System","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00381-024-06618-y","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/9/24 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose: Selective dorsal rhizotomy (SDR) and intrathecal baclofen (ITB) pump placement are two surgical options in children affected by spasticity secondary to cerebral palsy ¹. The latest literature is an enlarging indication for SDR in case of ITB failure in non-ambulant patients as an alternative to pump reimplantation to reduce spasticity and facilitate patients' care.

Methods: A retrospective single-center study has screened all children diagnosed with spastic tetraparesis who underwent in the last 10 years SDR and had previously ITB pump implanted. A cohort of six patients was pooled out. Furthermore, pertinent literature has been reviewed.

Results: Indication for pump removal was pump pocket infection, parents' decision, and poor response to ITB. Patients' amount of lifetime with the pump implanted has been 6.9 years. The preoperative and postoperative Ashworth scores were statistically different in both procedures (p = 0.005 and p = 0.,02).

Conclusions: Only two studies investigated the pediatric population undergoing SDR in the occurrence of ITB pump removal. Authors are offering SDR to all children, regardless of GMFCS groups and previous ITB pump placement. In conclusion, SDR represents a valid tool in neurosurgeon's hands to help ameliorate patients' long-lasting quality of life, reducing the severity of the spasticity and leading to better management by caregivers.

查看原文本刊更多论文

巴氯芬鞘内泵移除后的选择性背侧根神经切断术：单中心经验和文献综述。

目的：选择性背根切断术（SDR）和鞘内巴氯芬（ITB）泵植入术是脑瘫继发性痉挛患儿的两种手术选择1。最新的文献表明，SDR的适应症不断扩大，在ITB失效的情况下，非坐姿障碍患儿可以选择SDR，而不是重新植入泵，以减轻痉挛并方便患者护理：一项回顾性单中心研究筛查了所有确诊为痉挛性四肢瘫的儿童，这些儿童在过去10年中接受了SDR手术，并曾植入过ITB泵。共筛选出六名患者。此外，还查阅了相关文献：结果：移除泵的原因包括泵袋感染、父母的决定以及对 ITB 反应不佳。患者植入泵的寿命为 6.9 年。两种手术的术前和术后 Ashworth 评分存在统计学差异（P = 0.005 和 P = 0.02）：结论：只有两项研究调查了接受SDR手术的儿科人群中发生ITB泵移除的情况。作者为所有儿童提供了 SDR，无论其属于哪个 GMFCS 组别，也无论其之前是否植入过 ITB 泵。总之，SDR是神经外科医生手中的一种有效工具，有助于改善患者的长期生活质量，减轻痉挛的严重程度，使护理人员更好地进行管理。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Child's Nervous System 医学-临床神经学

CiteScore

3.00

自引率

7.10%

发文量

322

审稿时长

3 months

期刊介绍： The journal has been expanded to encompass all aspects of pediatric neurosciences concerning the developmental and acquired abnormalities of the nervous system and its coverings, functional disorders, epilepsy, spasticity, basic and clinical neuro-oncology, rehabilitation and trauma. Global pediatric neurosurgery is an additional field of interest that will be considered for publication in the journal.