Article

Single Event Multilevel Surgery (SEMLS) is considered the standard of
care to improve gait and function in children with bilateral spastic cerebral
palsy (BSCP). We have demonstrated in a randomized controlled trial (RCT) of
SEMLS, that gait was improved at 12 months after surgery and gross motor function
at 24 months after surgery. The question addressed in this study, was to
determine if improvements in gait and function, would be maintained at 5 year
follow-up. METHODS: Nineteen children with BSCP, GMFCS levels II (14 children)
and III (5 children), mean age 9.7 years (range 7.7-12.2 years) participated in a
prospective cohort study following participation in a RCT, with follow-up to 5
years. Outcome measures were Gait Profile Score (GPS), Gillette Gait Index (GGI),
Gait Deviation Index (GDI), Gross Motor Function Measure (GMFM66) and Functional
Mobility Scale (FMS). RESULTS: Eighteen children have completed follow-up, with
interval analysis at 1, 2 and 5 years post SEMLS. One child was excluded because
of neurological deterioration and his diagnosis was revised to Hereditary Spastic
Paraparesis (HSP). GPS improved by 5.29 degrees and GMFM66 by 3.3% at 5 years
post SEMLS. Differences between outcome measures at 1 versus 5 years and 2 versus
5 years (except GMFM66) were not significant, indicating that improvements in
gait and gross motor function were stable over time. CONCLUSIONS: SEMLS results
in clinically and statistically significant improvements in gait and function, in
children with BSCP, which were maintained at 5 years after surgery.
CI - Crown Copyright (c) 2012. Published by Elsevier B.V. All rights reserved.

Langue : ANGLAIS