Transition Child to Adult for Walking Cerebral Palsy patients.
Seance of wednesday 06 december 2023 (l'ANC reçoit la SOFCOT : Table ronde Transition Enfant/Adulte du sujet Paralysé Cérébral marchant)
DOI number : 10.26299/1g3j-ea53/emem.2023.35.02
Abstract
Selective dorsal rhizotomy (SDR) is an effective surgical treatment for spastic diplegia in GMFCS II
and III and usually, intrathecal baclofen has traditionally been the surgical treatment of choice for
adult patients. Can we do it for older patients and what do we expect?
From 2019 to 2022 in our center 264 patients were operated for SDR by single neurosurgeon.
From 3 to 35 years old. We studied motor, urological, pain, and quality of life.
For motor: Sustained improvement of spasticity over a long period of follow-up. At least at 10 to 25 years after surgery for Lower limbs, AND Upper limbs and m
For Urology: Sustained improvement 1-year period of follow-up for GMFCS IV and V
For Pain: Most of all have a real improvement.
For quality of life: Improvement: GMFCS VI 27-43% and GMFCS V 45-53%
SDR is a safe and useful intervention for targeted patients even for adult’s ones, but surgeon are afraid
Patients. SDR is a pain Killer in most of the time. Spastic quadriplegia is effectively managed:
Lower limb spasticity = Upper limb muscle groups MOST OF ALL Quality of life for young and older patients.
S. James MD (neurosurgery, Hospital Necker Enfants Malades)
and III and usually, intrathecal baclofen has traditionally been the surgical treatment of choice for
adult patients. Can we do it for older patients and what do we expect?
From 2019 to 2022 in our center 264 patients were operated for SDR by single neurosurgeon.
From 3 to 35 years old. We studied motor, urological, pain, and quality of life.
For motor: Sustained improvement of spasticity over a long period of follow-up. At least at 10 to 25 years after surgery for Lower limbs, AND Upper limbs and m
For Urology: Sustained improvement 1-year period of follow-up for GMFCS IV and V
For Pain: Most of all have a real improvement.
For quality of life: Improvement: GMFCS VI 27-43% and GMFCS V 45-53%
SDR is a safe and useful intervention for targeted patients even for adult’s ones, but surgeon are afraid
Patients. SDR is a pain Killer in most of the time. Spastic quadriplegia is effectively managed:
Lower limb spasticity = Upper limb muscle groups MOST OF ALL Quality of life for young and older patients.
S. James MD (neurosurgery, Hospital Necker Enfants Malades)