DOES GAIT CONTINUE TO IMPROVE 2 YEARS AFTER SELECTIVE DORSAL RHIZOTOMY

Although changes in the gait pattern of children with spastic diplegia 1 year after selective dorsal rhizotomy have been well documented, mi nimal information exists regarding the continued changes in the gait p attern over time. Despite improvements in gait after rhizotomy, 66-75% of patients still require orthopaedic surgery for residual deformitie s. The optimal timing of the orthopaedic surgery after selective dorsa l rhizotomy is not well established because of the lack of information regarding changes in gait over a long term. Using three-dimensional g ait analysis, the gait pattern of 23 children was evaluated preoperati vely, 1 and 2 years postoperatively. There were significant improvemen ts in hip, knee, and ankle motion at 1 year after surgery. Although im provements in the gait pattern were found between 1 and 2 years after surgery, the changes were not significant. Therefore orthopaedic inter vention may be undertaken at 1 year after rhizotomy to enhance functio n, as changes in gait from 1 to 2 years after rhizotomy are minimal.