Jones Mark D, Gardner Richard, Pyman Jane, Gargan Martin F, Witherow Peter, Monsell Fergal
Brighton and Sussex University Hospitals NHS Trust.
Cure International, Addis Ababa, Ethiopia.
J Pediatr Orthop. 2020 Aug;40(7):351-356. doi: 10.1097/BPO.0000000000001522.
This long-term consecutive, retrospective single-center cohort study evaluates long-term outcomes of single-event multilevel surgery in diplegic cerebral palsy with respect to functional status, gait, and patient satisfaction.
All patients with diplegic cerebral palsy who underwent single-event multilevel surgery >10 years previously were included. Retrospective gait assessment was performed using the Edinburgh Visual Gait Score (EVGS) and Gillette Functional Assessment Questionnaire Walking Scale (FAQWS) preoperatively and at midterm postoperative follow-up (median 2.6 y) and prospectively at most recent review [median 18 y, interquartile (IQ) range: 14.4 to 20.5 y]. The Short Form-36 (SF-36) was used prospectively to evaluate outcome compared with population norms for adults from the UK.
The complete assessment was possible in 26 of 39 patients who met the inclusion criteria. There was a statistically significant improvement at most recent follow-up compared with the preoperative assessment for EVGS and FAQWS [Wilcoxon Matched Pairs Signed Rank test -4.42 (P<0.0001) and 3.98 (P=0.0001), respectively]. The median Physical Health and Mental Health Component Summary scores for the SF-36 were 43.0 (IQ range: 32.8 to 46.8) and 55.3 (IQ range: 46.1 to 61.1), respectively.
This study demonstrates significant long-term improvements in function, independence and patient satisfaction that continue into adulthood. This will inform discussions with patients and families considering this treatment option.
Level IV-Retrospective cohort study.
这项长期连续性回顾性单中心队列研究评估了双侧瘫脑瘫患者单期多节段手术在功能状态、步态和患者满意度方面的长期疗效。
纳入所有10年多前接受单期多节段手术的双侧瘫脑瘫患者。术前、术后中期随访（中位时间2.6年）采用爱丁堡视觉步态评分（EVGS）和吉列功能评估问卷步行量表（FAQWS）进行回顾性步态评估，并在最近一次复查时（中位时间18年，四分位间距：14.4至20.5年）进行前瞻性评估。前瞻性地使用简明健康状况调查量表（SF-36）与英国成年人的总体标准进行比较来评估结果。
39例符合纳入标准的患者中，26例可进行完整评估。与术前评估相比，最近一次随访时EVGS和FAQWS均有统计学显著改善[Wilcoxon配对符号秩和检验分别为-4.42（P<0.0001）和3.98（P=0.0001）]。SF-36的身体健康和心理健康分量表总分中位数分别为43.0（四分位间距：32.8至46.8）和55.3（四分位间距：46.1至61.1）。
本研究表明，功能、独立性和患者满意度在成年期仍有显著的长期改善。这将为与考虑该治疗方案的患者及其家属的讨论提供参考。
IV级-回顾性队列研究。
