Single Event Multilevel Soft Tissue Release in Spastic Diplegic Cerebral Palsy

Document Type : Original Article

Authors

1 Orthopedic Surgery Resident at National Institute of Neuromotor System, Giza, Egypt.

2 Orthopedic Surgery Department, Faculty of Medicine for Boys, Al-Azhar University, Cairo, Egypt.

https://doi.org/10.21608/aimj.2025.446494

Abstract

Background: Single Event Multilevel Surgery (SEMLS) considered the main approach for correcting the deformities concerning the cerebral palsy patients.
Aim: Correct the contracture and deformities in hip, knee, ankle and foot in CP children to improve movement, gait, quality of life and increase independency of the patient.
Patients and methods: This was a prospective interventional study carried out on 12 CP spastic diplegic patients attending in Al-Hussein university hospital and National Institute of Neuromotor System (NINMS) outpatient clinic and managed by lower limb single event multilevel soft tissue release. Assessment was done using GMFCM-88, ROM score and spasticity score at 3 months and 6 months postoperative.
Results: SEMLS performed on spastic diplegic CP patients generated a positive outcome, with a significant difference from preoperative 32.0 (IQR=28.5-34.0) and 42 (IQR=38.5-44.75) at 3 months follow-up and 46 (IQR=41.25-50.25) at 6 months follow-up with p value < 0.05. Spasticity score significantly decreased from preoperative (m= 23.08, SD=3.605) and (m=14.08, SD=4.379) at 3 months follow-up, and (m=10.33, SD=3.284) at 6 months follow-up, with p value < 0.05. ROM score significantly decreased from preoperative (m=3.67, SD=8.15) and (m=25.17, SD=7.27) at 3 months follow-up, and (m=20.42, SD=6.11) at 6 months follow-up, with a p value < 0.05.
Conclusions: SEMLS is considered effective in correcting deformities with only soft tissue release in spastic diplegic CP patients with minimal complications.
 

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