Comparison of single event multilevel surgery and multiple surgical events in the lower extremities of children with spastic cerebral palsy.

Abstract

OBJECTIVES This study aims to compare patients treated with single event multilevel surgery (SEMS) and multiple surgical events (MSE) for disorders of the lower extremities due to cerebral palsy (CP). PATIENTS AND METHODS The study included 130 patients (74 males, 56 females; mean age 7.7±4 years; range, 4 to 13 years) who were retrospectively staged preoperatively and at the final follow-up with the Gross Motor Function Classification System (GMFCS). The patients were divided into two groups as group 1 (MSE) and group 2 (SEMS). Gross Motor Function Measure-88 (GMFM-88) was used as evaluation criteria and visual analog scale was used to measure family satisfaction. RESULTS In the final follow-up, group 2 had better GMFM-88 D and E scores (p=0.037 and p=0.045, respectively). Similarly, family satisfaction was better in group 2 (p=0.047). There was a difference between preoperative and final follow-up GMFCS stages (I, II, III) of all patients (21÷53÷56 and 53÷49÷28; respectively, p<0.001). A total of 3.8 (range, 2-7) operations were performed per child. CONCLUSION In this study, SEMS contributed significantly to movement, posture and independence of children with CP compared to MSE. Single event multilevel surgery also increased family satisfaction.