Article

Single event multilevel surgery (SEMLS) has become a standard intervention for
children with cerebral palsy (CP). SEMLS proved to improve the gait in bilateral
spastic cerebral palsy and those improvements can be maintained in the long term.
However there is no evidence on the long-term outcome of unilateral SEMLS in
children with unilateral spastic cerebral palsy. The gait analyses and clinical
data of 14 children (9 male/5 female, mean age 12.1) with unilateral CP (6
children Gross Motor Function Classification System Scale level I and 8 children
level II) were retrospectively reviewed at four time-points: preoperatively,
1year, 3-5 years and approximately 10 years after unilateral SEMLS. The Gait
Profile Score (GPS) of the affected leg was used as a main and the number of fine
tuning procedures as well as complications rate (Clavien-Dindo classification) as
secondary outcome measures. The gait improved postoperatively and the GPS of the
affected leg significantly declined by 3.73 degrees which is well above the
minimal clinical important difference of 1.6 degrees . No deterioration of GPS
occurred throughout the follow-up period. Therefore the postoperative improvement
was maintained long-term. However, additional fine-tuning procedures had to be
performed during the follow-up in 5 children and three complications occurred
(one level II and two level III). The results indicate that children with
unilateral cerebral palsy benefit from unilateral SEMLS and maintain gait
improvements long-term.
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