[Prognostic factors of GMFCS class improvement after selective dorsal rhizotomy in children with cerebral palsy].

Abstract

Selective dorsal rhizotomy (SDR) is a surgical method for children with spastic cerebral palsy (CP). In addition to reducing spasticity, some patients experience significant improvement of functional status after surgery (GMFCS class).

Objective: To identify additional prognostic factors of GMFCS functional class improvement following SDR in children with spastic CP.

Material and methods: A retrospective analysis of treatment outcomes included 71 patients aged 2-16 years who underwent SDR between 2022 and 2024. As a part of pre- and postoperative in-hospital examination, we analyzed muscle tone using the modified Ashworth scale (MAS) and GMFCS functional class. Preoperative brain MRI data were also taken into account. Telephone survey was conducted to assess long-term outcomes in follow-up period from 2 months to 2 years 11 months (mean 1 year 1 month 10 days).

Results: When evaluating significance of various prognostic factors, such as age, baseline GMFCS class, patient socialization before surgery, botulinum toxin therapy, motor rehabilitation, and orthopedic interventions before and after surgery, as well as severity of structural brain changes according to MRI data, we found no significant association with more favorable functional outcomes.

Conclusion: Our data may substantiate intermediate functional classes, detailed functional status assessment scales, and monitoring of systemic rehabilitation according to individual characteristics with subsequent analysis of treatment outcomes in these groups.