Comparison of single event multilevel surgery and multiple surgical events in the lower extremities of children with spastic cerebral palsy
Ahmet Aslan1, Sabri Kerem Diril2, Demir Demirci3, Hüseyin Yorgancıgil4
1Department of Orthopedics and Traumatology, Alanya Alaaddin Keykubat University, Faculty of Medicine, Antalya, Turkey
2Department of Orthopedics and Traumatology, University of Health Sciences, İstanbul Kanuni Sultan Süleyman SUAM, Istanbul, Turkey
3Department of Orthopedics and Traumatology, Isparta City Hospital, Isparta, Turkey
4Department of Orthopedics and Traumatology, Private Isparta Hospital, Isparta, Turkey
Keywords: Cerebral palsy, single event multilevel surgery, spasticity.
Objectives: This study aims to compare patients treated with single event multilevel surgery (SEMS) and multiple surgical events (MSE) for disorders of the lower extremities due to cerebral palsy (CP).
Patients and methods: The study included 130 patients (74 males, 56 females; mean age 7.7±4 years; range, 4 to 13 years) who were retrospectively staged preoperatively and at the final follow-up with the Gross Motor Function Classification System (GMFCS). The patients were divided into two groups as group 1 (MSE) and group 2 (SEMS). Gross Motor Function Measure-88 (GMFM-88) was used as evaluation criteria and visual analog scale was used to measure family satisfaction.
Results: In the final follow-up, group 2 had better GMFM- 88 D and E scores (p=0.037 and p=0.045, respectively). Similarly, family satisfaction was better in group 2 (p=0.047). There was a difference between preoperative and final followup GMFCS stages (I, II, III) of all patients (21/53/56 and 53/49/28; respectively, p<0.001). A total of 3.8 (range, 2-7) operations were performed per child.
Conclusion: In this study, SEMS contributed significantly to movement, posture and independence of children with CP compared to MSE. Single event multilevel surgery also increased family satisfaction.