Currently, I am working as a clinical research assistant at St. Louis Children's Hospital studying the surgical impact of selective dorsal rhizotomy and percutaneous muscle lengthening on cerebral palsy patient outcomes.
Spastic cerebral palsy is a neurological condition that results from brain damage to the motor cortex during early development and is characterized by motor impairment due to an involuntary, abnormal increase of muscle tone called spasticity. One common form of relieving this muscle tightness is to perform a surgical procedure called a selective dorsal rhizotomy (SDR) that sections sensory nerve fibers causing spasticity in the spinal cord. While this procedure has been shown to successfully reduce spasticity, muscles innervated by dorsal spinal nerves, such as hamstring and gastrocnemius muscles, and their tendons usually require lengthening to relieve preexisting muscle contractures and improve mobility. A minimally invasive follow-up procedure, called a selective percutaneous muscle (myofascial) lengthening (PERCS), is sometimes recommended to patients exhibiting contractures and is supplemented with physical therapy for at least another 2 years.
The Center for Cerebral Palsy Spasticity at St. Louis Children’s Hospital (SLCH) is the world’s premier institution for selective dorsal rhizotomy and one of the only hospitals that offers a combined PERCS/SDR treatment option. At SLCH, over 500 patients have received both these procedures by Dr. Matthew Dobbs and world-leading rhizotomy surgeon Dr. Tae Sung Park. Having this uniquely specific population at our disposal allows us to better understand the outcomes of these procedures in a large patient population and to assess the degree of improved function and mobility that PERCS/SDR treatment can provide for patients with spastic cerebral palsy.
The purpose of our retrospective study is to investigate the risk and benefits of combined surgical selective percutaneous myofascial lengthening (PERCS) and selective dorsal rhizotomy (SDR) in cerebral palsy patients. While several studies have assessed the effects of these procedures on functional improvement and mobility in children separately, their combined outcomes have not been well described. In order to obtain measurable assessments for quality of life in these patients, we are contacting them with a questionnaire that will be delivered via email or postal mail. These questions relate to health, mobility, independence, and general life satisfaction. We will also collect information regarding any additional treatments or surgeries.
Park T, Liu J L, Edwards C, et al. (May 17, 2017) Functional Outcomes of Childhood Selective Dorsal Rhizotomy 20 to 28 Years Later. Cureus 9(5): e1256. doi:10.7759/cureus.1256
Park T, Edwards C, Liu J L, et al. (March 05, 2017) Beneficial Effects of Childhood Selective Dorsal Rhizotomy in Adulthood. Cureus 9(3): e1077. doi:10.7759/cureus.1077