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Selective dorsal rhizotomy: A multidisciplinary approach to treating spastic diplegia

BACKGROUND: Spasticity is a motor disorder that interferes with mobility and affects the quality of life. Different approaches have been utilized to address patients with spastic diplegia, among which is selective dorsal rhizotomy (SDR). Although SDR has been shown to be efficacious in treating spas...

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Autores principales: Abou Al-Shaar, Hussam, Imtiaz, Muhammad Tariq, Alhalabi, Hazem, Alsubaie, Shara M., Sabbagh, Abdulrahman J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5532931/
https://www.ncbi.nlm.nih.gov/pubmed/28761524
http://dx.doi.org/10.4103/1793-5482.175625
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author Abou Al-Shaar, Hussam
Imtiaz, Muhammad Tariq
Alhalabi, Hazem
Alsubaie, Shara M.
Sabbagh, Abdulrahman J.
author_facet Abou Al-Shaar, Hussam
Imtiaz, Muhammad Tariq
Alhalabi, Hazem
Alsubaie, Shara M.
Sabbagh, Abdulrahman J.
author_sort Abou Al-Shaar, Hussam
collection PubMed
description BACKGROUND: Spasticity is a motor disorder that interferes with mobility and affects the quality of life. Different approaches have been utilized to address patients with spastic diplegia, among which is selective dorsal rhizotomy (SDR). Although SDR has been shown to be efficacious in treating spastic patients, many neurologists and neurosurgeons are not well aware of the procedure, its indications, and expected outcomes due to the limited number of centers performing this procedure. OBJECTIVES: The aim of this study is to describe the collaborative multidisciplinary approach between neurosurgeons, neurophysiologists, and physiotherapists in performing SDR. In addition, we delineate three illustrative cases in which SDR was performed in our patients. MATERIALS AND METHODS: A retrospective review and analysis of the clinical records of our three patients who underwent SDR was conducted and reported. Patients’ outcomes were evaluated and compared to preoperative measurements based on clinical examination of power, tone (Ashworth scale), gait, and range of motion, as well as subjective functional assessment, gross motor function classification system, and gross motor function measure with follow-up at 6, 12, and 24 months postoperatively. A detailed description of our neurosurgical technique in performing SDR in collaboration with neurophysiology and physiotherapy monitoring is provided. RESULTS: The three patients who underwent SDR using our multidisciplinary approach improved both functionally and objectively after the procedure. No intraoperative or postoperative complications were encountered. All patients were doing well over a long postoperative follow-up period. CONCLUSION: A multidisciplinary approach to treating spastic diplegia with SDR can provide good short-term and long-term outcomes in select patients suffering from spastic diplegia.
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spelling pubmed-55329312017-07-31 Selective dorsal rhizotomy: A multidisciplinary approach to treating spastic diplegia Abou Al-Shaar, Hussam Imtiaz, Muhammad Tariq Alhalabi, Hazem Alsubaie, Shara M. Sabbagh, Abdulrahman J. Asian J Neurosurg Original Article BACKGROUND: Spasticity is a motor disorder that interferes with mobility and affects the quality of life. Different approaches have been utilized to address patients with spastic diplegia, among which is selective dorsal rhizotomy (SDR). Although SDR has been shown to be efficacious in treating spastic patients, many neurologists and neurosurgeons are not well aware of the procedure, its indications, and expected outcomes due to the limited number of centers performing this procedure. OBJECTIVES: The aim of this study is to describe the collaborative multidisciplinary approach between neurosurgeons, neurophysiologists, and physiotherapists in performing SDR. In addition, we delineate three illustrative cases in which SDR was performed in our patients. MATERIALS AND METHODS: A retrospective review and analysis of the clinical records of our three patients who underwent SDR was conducted and reported. Patients’ outcomes were evaluated and compared to preoperative measurements based on clinical examination of power, tone (Ashworth scale), gait, and range of motion, as well as subjective functional assessment, gross motor function classification system, and gross motor function measure with follow-up at 6, 12, and 24 months postoperatively. A detailed description of our neurosurgical technique in performing SDR in collaboration with neurophysiology and physiotherapy monitoring is provided. RESULTS: The three patients who underwent SDR using our multidisciplinary approach improved both functionally and objectively after the procedure. No intraoperative or postoperative complications were encountered. All patients were doing well over a long postoperative follow-up period. CONCLUSION: A multidisciplinary approach to treating spastic diplegia with SDR can provide good short-term and long-term outcomes in select patients suffering from spastic diplegia. Medknow Publications & Media Pvt Ltd 2017 /pmc/articles/PMC5532931/ /pubmed/28761524 http://dx.doi.org/10.4103/1793-5482.175625 Text en Copyright: © 2016 Asian Journal of Neurosurgery http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Original Article
Abou Al-Shaar, Hussam
Imtiaz, Muhammad Tariq
Alhalabi, Hazem
Alsubaie, Shara M.
Sabbagh, Abdulrahman J.
Selective dorsal rhizotomy: A multidisciplinary approach to treating spastic diplegia
title Selective dorsal rhizotomy: A multidisciplinary approach to treating spastic diplegia
title_full Selective dorsal rhizotomy: A multidisciplinary approach to treating spastic diplegia
title_fullStr Selective dorsal rhizotomy: A multidisciplinary approach to treating spastic diplegia
title_full_unstemmed Selective dorsal rhizotomy: A multidisciplinary approach to treating spastic diplegia
title_short Selective dorsal rhizotomy: A multidisciplinary approach to treating spastic diplegia
title_sort selective dorsal rhizotomy: a multidisciplinary approach to treating spastic diplegia
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5532931/
https://www.ncbi.nlm.nih.gov/pubmed/28761524
http://dx.doi.org/10.4103/1793-5482.175625
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