Article

The purpose of this study was to use three-dimensional gait analysis to describe
the gait status of adults with spastic diplegia who underwent selective dorsal
rhizotomy (SDR) in childhood. Outcome measures were the gait deviation index
(GDI), non-dimensional temporal-distance parameters, and kinematics of the lower
limbs. A total of 31 adults with spastic diplegia who had previously undergone
SDR were eligible and participated in current study (SDR group). These
participants had a median age of 26.8 years (range 21-44 years) with a mean time
between surgery and assessment of 21.2+/-2.9 years (range 17-26 years). For
comparison purposes, 43 typically developed adults also participated (CONTROL
group), with a median age of 28.3 years (range 21-45 years). More than 17 years
after SDR 58% of the SDR group showed improved GMFCS levels, while none of them
deteriorated. The participants in the SDR group walked with a mild crouch gait,
although there was a loading response, adequate swing-phase knee flexion,
adequate swing-phase plantarflexion, reasonable speed and cadence. The gait
status of the SDR group more than 17 years after SDR was similar to what has been
reported in short-term follow-up studies, as well as our earlier 20 year
follow-up study that did not include 3D gait analysis. Appropriate orthopaedic
intervention was required in 61% of the study cohort. Whether the types and
numbers of orthopaedic interventions are positively affected by SDR remains an
open question. Further studies examining this question are warranted. In
addition, long-term follow-up studies focused on other interventions would also
be of clinical relevance.
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