Evaluation of Single Event Multilevel Surgery (SEMLS) in Cerebral Palsy Children with Lower Limb Deformities

Abstract

Background: For ambulatory cases with spastic diplegic cerebral palsy, single event multilevel surgery (SEMLS) has replaced previous methods of treatment for improving gait. This research aimed for investigation if single event multilevel surgery improved gait and function among cases with spastic cerebral palsy. Patients and methods: This was a prospective interventional study carried out on 24 children with spastic lower limbs attending to pediatric orthopedic unit in Zagazig University Hospital and managed with lower limb single event multilevel surgery. Clinical as well as radiological assessments were applied pre- and 6 months post-operative. Results: Single event multi-level surgeries performed in the children with CP generated positive outcomes in the GMFM which changed significantly from (45.67±3.70) in the preoperative assessment to (52.63±3.34) in follow up after 2 years postoperative with p value<0.001. A paired samples t-test revealed that spasticity significantly decreased from pre- (M=15.46, SD=2.187) to post- (M=10.71, SD=2.293) intervention, t(23)=17.53, p<.05, d=1.327, for Spasticity (after intervention) a statistically significant difference was found between groups (2, 21) = 17.502, p < 0.001. Also, a marked improvement occurred in the range of motion (ROM) as determined by ROM score which changed from (44.67±8.67) preoperatively to (33.00±9.09) after 6 months with P value <0.001. Conclusion: The results of SEMLS regarding deformity correction and quality of life improvement are considered satisfactory with minimal complications