Outcome of Single Event Multilevel Soft Tissue Release
for Spastic Diplegic Cerebral Palsy
Pawin Gajaseni MD*, Pattanaket Cheewakongkiat MD*,
Panya Surijamorn MD*, Thammanoon Srisaarn MD*
Affiliation :
* Department of Orthopedics, Phramongkutklao Hospital and College of Medicine, Bangkok, Thailand
Objective : We evaluated the results of single event multilevel surgery for treatment of contractures of lower extremities in
spastic diplegic cerebral palsy patients in Phramongkutklao Hospital.
Material and Method: The present study included 40 patients (23 boys, 17 girls, mean age 8.9 years) with spastic diplegic
cerebral palsy, who underwent single event multilevel surgery for the treatment of soft tissue contractures in lower extremities
secondary to spasticity between 2006 and 2009. Evaluations were based on pre- and post-operative (follow-up for three
years), physical examination, and video observational gait pattern on the Gross Motor Function Classification System
(GMFCS) scores and Functional Mobility scales (FMS).
Results : Range of motion of all operated joints were increased post-operatively, resulting in significant improvement in
posture, gait, and balance of patients. The mean GMFCS scores were 4.2 pre-operatively, 4.1 at post-operatively 1-year,
3.8 at post-operative 2-year, and 3.0 at post-operative 3-year, which were significantly improved two and three years
post-operative period (p<0.05). The mean FMS scores were improved at 5 meters post-operative at 1-, 2-, and 3-year
(p<0.05). The mean FMS scores at 50 meters were improved at 3-year post-operative period.
Conclusion : Single event multilevel surgery can help spastic diplegic cerebral palsy patients improve range of motions,
gait patterns, and mobility functions.
Keywords : Cerebral palsy, Single event multilevel surgery, Gross motor function classification system (GMFCS) scores,
Functional mobility scale (FMS)
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