Single event multilevel surgery in spastic patient : a Hospital Tengku Ampuan Afzan (HTAA) experience

Nik Abdul Adel, Nik Alyani and Abdul Razak, Ardilla Hanim and Awang, Mohd Shukrimi and Loh, LL (2020) Single event multilevel surgery in spastic patient : a Hospital Tengku Ampuan Afzan (HTAA) experience. In: Sarawak Paediatric Orthoapedic Symposium, 10th-12th January 2020, Kuching, Sarawak. (Unpublished)

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Abstract

INTRODUCTION: Single event multilevel surgery (SEMLS) is common procedure to improve gait and functioning of children with spastic cerebral palsy(CP).These series is aim to observe post-operative outcomes of gross motor function (GMFCS) and hip migration index (MI). MATERIALS & METHODS: Patient underwent SEMLS at HTAA from 2014 to 2018.Data were data taken from case notes during follow-up at rehabilitation clinic. RESULTS: There were 10 patients, 6 were boys.Mean age at surgery was 6.6 years old.7 having spastic diplegic and 1 each having triplegic and quadriplegic CP. Table 1: Type of surgery Patient Adductor release Hamstring release Gastrocnemius recession Tendon achilles lengthening Posteromedial release 1 bilateral bilateral 2 bilateral bilateral bilateral 3 bilateral bilateral 4 bilateral bilateral 5 bilateral bilateral Left 6 bilateral bilateral 7 bilateral 8 bilateral bilateral 9 bilateral bilateral 10 bilateral bilateral 2 patients had second surgery at 1 year apart:1 underwent talipes equinovarus deformity correction and another had repeated SEMLS.Only 5patients had pre and post-operative pelvis radiograph where 4 patients(80%) improved in hip MI. Table 2: Improvement of GMFCS level Patient GMFCS Level improvement Pre Post 1 IV III 1 level 2 II II 0 3 III III 0 4 IV III 1 level 5 V V 0 6 IV III 1 level 7 IV IV 0 8 III II 1 level 9 III III 0 10 V V 0 40% of patients have 1 level improvement. 75% of patients with GMFCS IV had improvement compared to GMFCS III (33%). DISCUSSIONS: 73.5% has good improvement of hip MI postoperatively with 0.3% risk of hip surgery1.Incidence of hip displacement related to GMFCS level2.Evidence proved SEMLS improved gait3 and stability of GMFCS4. CONCLUSION: SEMLS may affect the improvement and stability of GMFCS level and hip MI; and that effect is level-dependent. REFERENCES: 1Terjesen et al,Acta Orthopeadica,2009. 2Kentish M.et al,Journal of Peadiatric Rehabilitation Medicine,2011. 3Thomason et al,JBJS,2011. 4Godwin et al,Journal of Peadiatric Orthopaedic,2009.

Item Type:	Conference or Workshop Item (Poster)
Additional Information:	8324/78831
Uncontrolled Keywords:	multilevel surgery, spastic patient
Subjects:	R Medicine > RD Surgery > RD701 Orthopedics
Kulliyyahs/Centres/Divisions/Institutes (Can select more than one option. Press CONTROL button):	Kulliyyah of Medicine > Department of Department of Orthopaedics, Traumatology & Rehabilitation Kulliyyah of Medicine
Depositing User:	Dr Nik Alyani Nik Abdul Adel
Date Deposited:	16 Jul 2020 10:12
Last Modified:	16 Jul 2020 10:12
URI:	http://irep.iium.edu.my/id/eprint/78831

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