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59th Annual Meeting of the German Society of Neurosurgery (DGNC)
3rd Joint Meeting with the Italian Neurosurgical Society (SINch)

German Society of Neurosurgery (DGNC)

1 - 4 June 2008, Würzburg

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Suprasegmental effects of selective posterior rhizotomy

Suprasegmentale Effekte der selektiven hinteren Rhizotomie

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  • corresponding author Daniel Hořínek - Department of Neurosurgery, First Medical Faculty, Charles University, Prague
  • D. Hoza - Department of Pediatric Neurosurgery, University Hospital Motol, Prague
  • R. Cerny - Department of Neurology, Second Medical Faculty, Charles University, Prague
  • M. Häckel - Department of Neurosurgery, First Medical Faculty, Charles University, Prague
  • M. Vyhnalek - Department of Neurology, Second Medical Faculty, Charles University, Prague
  • P. Liby - Department of Pediatric Neurosurgery, University Hospital Motol, Prague
  • J. Vokral - Department of Phoniatrics, First Medical School, Charles University, Prague
  • M. Tichy - Department of Pediatric Neurosurgery, University Hospital Motol, Prague

Deutsche Gesellschaft für Neurochirurgie. Società Italiana di Neurochirurgia. 59. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3. Joint Meeting mit der Italienischen Gesellschaft für Neurochirurgie (SINch). Würzburg, 01.-04.06.2008. Düsseldorf: German Medical Science GMS Publishing House; 2008. DocMO.04.07

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2008/08dgnc063.shtml

Published: May 30, 2008

© 2008 Hořínek et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective: Beside the intrathecal Baclofen, selective posterior rhizotomy (SPR) still represents an effective and valuable tool in the reduction of severe spasticity in children with cerebral palsy (CP). Along with the decrease of spasticity in legs, the improvement of fine motor skills has been observed in patients after SPR. The aims of this study were to demonstrate the improvement of speech fluency and eye movements in children with CP.

Methods: 25 children with CP (16 boys, 9 girls; age 13,2±4,7) and severe spasticity underwent SPR. In all children Ashworth scale was performed to assess the severity of spasticity pre- and postoperatively.

An acoustic analysis was carried out to determine the changes in speech fluency in 13 patients. Standard deviation of fundamental frequency of voice, shimmer and jitter were the parameters of measure of voice quality. Video-oculography was used for pursuit eye movement registration in 7 patients.

Results: Spasticity was reduced markedly both in upper and lower extremities (p<0,001). The parameters of speech fluency improved significantly after surgery (p<0,05). 4 from seven subjects manifested a decrease of spontaneous nystagmus on pursuit eye movement analysis.

Conclusions: We were able to demonstrate the improvement of speech fluency and decrease of spontaneous nystagmus after SPR. These suprasegmental effects may be interpreted as the decrease of pathological reflex response on higher anatomical levels including brainstem and cerebral cortex. Suprasegmental effects may be beneficial for the quality of life of children undergoing SPR.

The project has been supported by IGA grant NR-8848