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Nelleke G Langerak - One of the best experts on this subject based on the ideXlab platform.
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selection criteria for selective dorsal Rhizotomy in children with spastic cerebral palsy a systematic review of the literature
Developmental Medicine & Child Neurology, 2014Co-Authors: Sebastian Grunt, Nelleke G Langerak, Graham A Fieggen, Jeroen R Vermeulen, Jules G BecherAbstract:AIM: Information regarding the selection procedure for selective dorsal Rhizotomy (SDR) in children with spastic cerebral palsy (CP) is scarce. Therefore, the aim of this study was to summarize the selection criteria for SDR in children with spastic CP. METHOD: A systematic review was carried out using the following databases: MEDLINE, CINAHL, EMBASE, PEDro, and the Cochrane Library. Additional studies were identified in the reference lists. Search terms included 'selective dorsal Rhizotomy', 'functional posterior Rhizotomy', 'selective posterior Rhizotomy', and 'cerebral palsy'. Studies were selected if they studied mainly children (<18y of age) with spastic CP, if they had an intervention of SDR, if they had a detailed description of the selection criteria, and if they were in English. The levels of evidence, conduct of studies, and selection criteria for SDR were scored. RESULTS: Fifty-two studies were included. Selection criteria were reported in 16 International Classification of Functioning, Disability and Health model domains including 'body structure and function' (details concerning spasticity [94%], other movement abnormalities [62%], and strength [54%]), 'activity' (gross motor function [27%]), and 'personal and environmental factors' (age [44%], diagnosis [50%], motivation [31%], previous surgery [21%], and follow-up therapy [31%]). Most selection criteria were not based on standardized measurements. INTERPRETATION: Selection criteria for SDR vary considerably. Future studies should describe clearly the selection procedure. International meetings of experts should develop more uniform consensus guidelines, which could form the basis for selecting candidates for SDR.
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level of activity and participation in adults with spastic diplegia 17 26 years after selective dorsal Rhizotomy
Journal of Rehabilitation Medicine, 2011Co-Authors: Nelleke G Langerak, Jean Hillier, Peter P J L Verkoeijen, Jonathan C Peter, Graham A Fieggen, Christopher L. VaughanAbstract:textabstractObjective: To evaluate the activity and participation levels of adults with spastic diplegia 17-26 years after selective dorsal Rhizotomy; to investigate relationships between subjects'functioning and age, socio-economic-status, level of satisfaction and their perceptions of the post-operative outcomes. Design: Observational follow-up study.Patients: Thirty-one subjects with spastic diplegia, age range 21-44 years, who underwent selective dorsal Rhizotomy between 1981 and 1991. Methods: A semi-structured interview was used to gather data on patients' characteristics and long-term experiences after the operation. The Functional Mobility Scale and Life-Habit questionnaire were completed.Results: Based on the Functional Mobility Scale 84% of subjects were reported as independent for a distance of 5 m, and 61% for 50 and 500 m. Eighty percent were independent in accomplishing all life habits, with most problems found for Mobility and Recreation. This was in agreement with the subjects' perception, with strong correlations between Life-Habit questionnaire accomplishment and satisfaction levels. No significant associations were found between functioning and age at selective dorsal Rhizotomy, current age and socioeconomic status. Conclusion: More than 15 years after selective dorsal Rhizotomy, adults with spastic diplegia showed high levels of functioning, and similar levels of satisfaction with life habits. The majority had positive feelings about the neurosurgical procedure, although there is a need for better follow-up after subjects leave school.
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incidence of spinal abnormalities in patients with spastic diplegia 17 to 26 years after selective dorsal Rhizotomy
Childs Nervous System, 2009Co-Authors: Nelleke G Langerak, Christopher L. Vaughan, Graham A Fieggen, Edward B Hoffman, Anthony A Figaji, Jonathan C PeterAbstract:Introduction The aim of this study was to evaluate the mechanical status of the spine in patients with spastic diplegia 17–26 years after selective dorsal Rhizotomy (SDR).
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selective dorsal Rhizotomy long term experience from cape town
Childs Nervous System, 2007Co-Authors: Nelleke G Langerak, Warwick J. Peacock, Jonathan C Peter, Graham A Fieggen, Robert P Lamberts, Christopher L. VaughanAbstract:Introduction Given the large number of cerebral palsy patients who have undergone selective dorsal Rhizotomy in the past two decades, it is clearly imperative that the clinical community be provided with objective and compelling evidence of the long-term sequelae of the procedure.
Michael B Horowitz - One of the best experts on this subject based on the ideXlab platform.
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long term outcomes of intradural cervical dorsal root Rhizotomy for refractory occipital neuralgia
Journal of Neurosurgery, 2016Co-Authors: Abhiram Gande, William E Rothfus, Michael B Horowitz, Srinivas Chivukula, John Moossy, Vikas Agarwal, Paul A GardnerAbstract:OBJECT Occipital neuralgia (ON) causes chronic pain in the cutaneous distribution of the greater and lesser occipital nerves. The long-term efficacy of cervical dorsal root Rhizotomy (CDR) in the management of ON has not been well described. The authors reviewed their 14-year experience with CDR to assess pain relief and functional outcomes in patients with medically refractory ON. METHODS A retrospective chart review of 75 ON patients who underwent cervical dorsal root Rhizotomy, from 1998 to 2012, was performed. Fifty-five patients were included because they met the International Headache Society's (IHS) diagnostic criteria for ON, responded to CT-guided nerve blocks at the C-2 dorsal nerve root, and had at least one follow-up visit. Telephone interviews were additionally used to obtain data on patient satisfaction. RESULTS Forty-two patients (76%) were female, and the average age at surgery was 46 years (range 16–80). Average follow up was 67 months (range 5–150). Etiologies of ON included the followin...
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refractory occipital neuralgia preoperative assessment with ct guided nerve block prior to dorsal cervical Rhizotomy
American Journal of Neuroradiology, 2003Co-Authors: Vibhu Kapoor, William E Rothfus, Stephen Z Grahovac, Stephen Amin Z Kassam, Michael B HorowitzAbstract:BACKGROUND AND PURPOSE: Occipital neuralgia syndrome can cause severe refractory headaches. In a small percentage of people, these headaches can be devastating and debilitating, with the potential for complete relief following surgical Rhizotomy. We describe CT fluoroscopy–guided percutaneous C2–C3 nerve block for the confirmation of diagnosis of occipital neuralgia and for demonstrating to patients the sensory effects of intradural cervical dorsal Rhizotomy before the definitive surgical procedure. METHODS: Seventeen patients with occipital neuralgia underwent 32 CT fluoroscopy–guided C2 or C2 and C3 nerve root blocks. Of the 17 patients, nine had occipital neuralgia following prior neck or skull base surgeries. On the basis of the positive results of the nerve blocks in terms of temporary pain relief, all 17 patients underwent unilateral (n = 16) or bilateral (n = 1) intradural C1 (n = 9), C2 (n = 17), C3 (n = 17), or C4 (n = 7) dorsal rhizotomies. All patients were followed up for a mean of 20 months (range, 5–37 months) for assessment of pain relief. Sixteen patients were assessed for degree of satisfaction with and functional state after surgery. RESULTS: All patients had temporary relief of symptoms after percutaneous CT-guided block (positive result) and felt that occipital numbness was an acceptable alternative to pain. Immediately after surgery, all patients had complete relief from pain. At follow-up, 11 patients (64.7%) had complete relief of symptoms, two (11.8%) had partial relief, and four (23.5%) had no relief. Seven of eight (87.5%) patients without prior surgery had complete relief of symptoms and one (12.5%) patient had partial relief, as opposed to complete relief in four of nine (44.4%), partial relief in one of nine (11.2%), and no relief in four of nine (44.4%) patients with a history of prior surgery. Because of the small number of patients, this difference was not statistically significant (P = .110). Eleven of 16 (68.8%) patients stated that the surgery was worthwhile. Eight of 16 (50%) patients felt they were more active and functional after surgery, whereas 25% felt they were either unchanged or less functional than before surgery. None of the patients without a history of prior surgery reported a decreased sense of functional activity following Rhizotomy. CONCLUSION: CT fluoroscopy–guided percutaneous cervical nerve block is useful for the confirmation of occipital neuralgia, for demonstrating to patients the sensory effects of nerve sectioning, and possibly as a guide for selection of patients for intradural cervical dorsal Rhizotomy. Although not statistically significant, there was a trend toward better response to Rhizotomy in patients without prior head or neck surgery.
Marie Andrie Cantin - One of the best experts on this subject based on the ideXlab platform.
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functional performance following selective posterior Rhizotomy long term results determined using a validated evaluative measure
Journal of Neurosurgery, 2002Co-Authors: Sandeep Mittal, Jean Pierre Farmer, Borhan Alatassi, Kathleen Montpetit, Nathalie Gervais, Chantal Poulin, Thierry E Benaroch, Marie Andrie CantinAbstract:Object. Selective posterior Rhizotomy (SPR) may result in considerable benefit for children with spastic cerebral palsy. To date, however, there have been few studies in which validated functional outcome measures have been used to report surgical results beyond 3 years. The authors analyzed data obtained from the McGill Rhizotomy Database to determine long-term functional performance outcomes in patients who underwent lumbosacral dorsal Rhizotomy performed using intraoperative electrophysiological monitoring. Methods. The study population was composed of children with debilitating spasticity who underwent SPR and were evaluated by a multidisciplinary team preoperatively and at 6 months and 1 year postoperatively. Quantitative standardized assessments of activities of daily living (ADL) were obtained using the Pediatric Evaluation of Disability Inventory (PEDI). Of 57 patients who met the entry criteria for the study, 41 completed the 3-year assessments and 30 completed the 5-year assessments. Statistical...
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long term functional outcome after selective posterior Rhizotomy
Journal of Neurosurgery, 2002Co-Authors: Sandeep Mittal, Jean Pierre Farmer, Borhan Alatassi, Chantal Poulin, Marie Andrie Cantin, Joanne Gibis, Eileen Kennedy, Carlo Galli, Guylaine Courchesnes, Thierry E BenarochAbstract:Object. Selective posterior Rhizotomy (SPR) is a well-recognized treatment for children with spastic cerebral palsy (CP). Few investigators have used quantitative outcome measures to assess the surgical results beyond 3 years. The authors analyzed data obtained from the McGill Rhizotomy Database to determine the long-term functional outcome of children who had undergone selective dorsal Rhizotomy accompanied by intraoperative electrophysiological monitoring. Methods. The study population was composed of children with spastic CP who underwent SPR and were evaluated by a multidisciplinary team preoperatively, and at 6 months and 1 year postoperatively. Quantitative standardized assessments of lower-limb spasticity, passive range of motion, muscle strength, and ambulatory function were obtained. Of the 93 patients who met the entry criteria for the study, 71 completed the 3-year and 50 completed the 5-year assessments, respectively. Statistical analysis demonstrated significant improvements in spasticity, ra...
Thierry E Benaroch - One of the best experts on this subject based on the ideXlab platform.
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functional performance following selective posterior Rhizotomy long term results determined using a validated evaluative measure
Journal of Neurosurgery, 2002Co-Authors: Sandeep Mittal, Jean Pierre Farmer, Borhan Alatassi, Kathleen Montpetit, Nathalie Gervais, Chantal Poulin, Thierry E Benaroch, Marie Andrie CantinAbstract:Object. Selective posterior Rhizotomy (SPR) may result in considerable benefit for children with spastic cerebral palsy. To date, however, there have been few studies in which validated functional outcome measures have been used to report surgical results beyond 3 years. The authors analyzed data obtained from the McGill Rhizotomy Database to determine long-term functional performance outcomes in patients who underwent lumbosacral dorsal Rhizotomy performed using intraoperative electrophysiological monitoring. Methods. The study population was composed of children with debilitating spasticity who underwent SPR and were evaluated by a multidisciplinary team preoperatively and at 6 months and 1 year postoperatively. Quantitative standardized assessments of activities of daily living (ADL) were obtained using the Pediatric Evaluation of Disability Inventory (PEDI). Of 57 patients who met the entry criteria for the study, 41 completed the 3-year assessments and 30 completed the 5-year assessments. Statistical...
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long term functional outcome after selective posterior Rhizotomy
Journal of Neurosurgery, 2002Co-Authors: Sandeep Mittal, Jean Pierre Farmer, Borhan Alatassi, Chantal Poulin, Marie Andrie Cantin, Joanne Gibis, Eileen Kennedy, Carlo Galli, Guylaine Courchesnes, Thierry E BenarochAbstract:Object. Selective posterior Rhizotomy (SPR) is a well-recognized treatment for children with spastic cerebral palsy (CP). Few investigators have used quantitative outcome measures to assess the surgical results beyond 3 years. The authors analyzed data obtained from the McGill Rhizotomy Database to determine the long-term functional outcome of children who had undergone selective dorsal Rhizotomy accompanied by intraoperative electrophysiological monitoring. Methods. The study population was composed of children with spastic CP who underwent SPR and were evaluated by a multidisciplinary team preoperatively, and at 6 months and 1 year postoperatively. Quantitative standardized assessments of lower-limb spasticity, passive range of motion, muscle strength, and ambulatory function were obtained. Of the 93 patients who met the entry criteria for the study, 71 completed the 3-year and 50 completed the 5-year assessments, respectively. Statistical analysis demonstrated significant improvements in spasticity, ra...
Sandeep Mittal - One of the best experts on this subject based on the ideXlab platform.
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functional performance following selective posterior Rhizotomy long term results determined using a validated evaluative measure
Journal of Neurosurgery, 2002Co-Authors: Sandeep Mittal, Jean Pierre Farmer, Borhan Alatassi, Kathleen Montpetit, Nathalie Gervais, Chantal Poulin, Thierry E Benaroch, Marie Andrie CantinAbstract:Object. Selective posterior Rhizotomy (SPR) may result in considerable benefit for children with spastic cerebral palsy. To date, however, there have been few studies in which validated functional outcome measures have been used to report surgical results beyond 3 years. The authors analyzed data obtained from the McGill Rhizotomy Database to determine long-term functional performance outcomes in patients who underwent lumbosacral dorsal Rhizotomy performed using intraoperative electrophysiological monitoring. Methods. The study population was composed of children with debilitating spasticity who underwent SPR and were evaluated by a multidisciplinary team preoperatively and at 6 months and 1 year postoperatively. Quantitative standardized assessments of activities of daily living (ADL) were obtained using the Pediatric Evaluation of Disability Inventory (PEDI). Of 57 patients who met the entry criteria for the study, 41 completed the 3-year assessments and 30 completed the 5-year assessments. Statistical...
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long term functional outcome after selective posterior Rhizotomy
Journal of Neurosurgery, 2002Co-Authors: Sandeep Mittal, Jean Pierre Farmer, Borhan Alatassi, Chantal Poulin, Marie Andrie Cantin, Joanne Gibis, Eileen Kennedy, Carlo Galli, Guylaine Courchesnes, Thierry E BenarochAbstract:Object. Selective posterior Rhizotomy (SPR) is a well-recognized treatment for children with spastic cerebral palsy (CP). Few investigators have used quantitative outcome measures to assess the surgical results beyond 3 years. The authors analyzed data obtained from the McGill Rhizotomy Database to determine the long-term functional outcome of children who had undergone selective dorsal Rhizotomy accompanied by intraoperative electrophysiological monitoring. Methods. The study population was composed of children with spastic CP who underwent SPR and were evaluated by a multidisciplinary team preoperatively, and at 6 months and 1 year postoperatively. Quantitative standardized assessments of lower-limb spasticity, passive range of motion, muscle strength, and ambulatory function were obtained. Of the 93 patients who met the entry criteria for the study, 71 completed the 3-year and 50 completed the 5-year assessments, respectively. Statistical analysis demonstrated significant improvements in spasticity, ra...
