{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T05:07:55Z","timestamp":1789189675829,"version":"build-2803163510"},"reference-count":21,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T00:00:00Z","timestamp":1789084800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T00:00:00Z","timestamp":1789084800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Develop Med Child Neuro"],"abstract":"<jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To establish the efficacy of combined dorsal and ventral rhizotomy (CDVR) and associated quality of life (QoL) changes in individuals with cerebral palsy (CP).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>This was a prospective and consecutive recruitment of patients undergoing CDVR analyzed using retrospective cohort analysis. Spasticity and dystonia were measured using the modified Ashworth and Barry\u2013Albright Dystonia Scales at 3 months and 12\u2009months after surgery. QoL was measured using the Caregiver Priorities and Child Health Index of Life with Disabilities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thirty\u2010three patients (21 males, 12 females) underwent CDVR between 2020 and 2025 at an average age of 14\u2009years 6 months; 91% were classified in Gross Motor Function Classification System level V. CDVR had a low complication rate (one wound infection and no cerebrospinal fluid leaks). Spasticity was improved in all patients at 12\u2009months by a median of 2 levels (preoperative: 3.0 [3.0\u20134.0] vs 1.0 [1.0\u20131.25] at 1\u2009year,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Dystonia improved at 12\u2009months (preoperative: 17.5 [10.0\u201321.25] vs 8.0 [3.25\u201310.5] at 12\u2009months,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.016). The Caregiver Priorities and Child Health Index of Life with Disabilities scores indicated improved QoL at 12\u2009months (33.8 [5.3] vs 48.1 [4.7],\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.012). All patients returned to their stander or gait assistive devices by 1\u2009year.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation<\/jats:title>\n                    <jats:p>CDVR is safe and effective in non\u2010ambulatory individuals with bilateral, mixed spastic\u2010dyskinetic CP and improves QoL without decreasing preoperative function.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dmcn.70456","type":"journal-article","created":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T04:30:52Z","timestamp":1789187452000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Combined dorsal and ventral rhizotomy in non\u2010ambulatory individuals with mixed spastic bilateral cerebral palsy: A prospective registry analysis"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9847-1262","authenticated-orcid":false,"given":"Adam C.","family":"Glaser","sequence":"first","affiliation":[{"name":"Department of Neurosurgery Boston Children's Hospital  Boston MA USA"},{"name":"Department of Neurosurgery Brigham and Women's Hospital  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-9789-7882","authenticated-orcid":false,"given":"Joon Hyeok","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Boston Children's Hospital  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8604-3751","authenticated-orcid":false,"given":"Kristin","family":"Buxton","sequence":"additional","affiliation":[{"name":"Cerebral Palsy Program Boston Children's Hospital  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nahyun","family":"Kim","sequence":"additional","affiliation":[{"name":"Cerebral Palsy Program Boston Children's Hospital  Boston MA USA"},{"name":"Department of Physical Medicine and Rehabilitation Spaulding Rehabilitation Hospital  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juliana","family":"Mariani","sequence":"additional","affiliation":[{"name":"Cerebral Palsy Program Boston Children's Hospital  Boston MA USA"},{"name":"Department of Pediatrics Boston Children's Hospital  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5380-4307","authenticated-orcid":false,"given":"Benjamin J.","family":"Shore","sequence":"additional","affiliation":[{"name":"Cerebral Palsy Program Boston Children's Hospital  Boston MA USA"},{"name":"Department of Orthopedic Surgery Boston Children's Hospital  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3019-1296","authenticated-orcid":false,"given":"Weston T.","family":"Northam","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Boston Children's Hospital  Boston MA USA"},{"name":"Cerebral Palsy Program Boston Children's Hospital  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,11]]},"reference":[{"issue":"2","key":"e_1_2_11_2_1","doi-asserted-by":"crossref","first-page":"217","DOI":"10.3171\/2025.2.PEDS24576","article-title":"Intrathecal baclofen pump versus combined dorsal\/ventral rhizotomy for spastic quadriplegia: healthcare cost and complication analysis","volume":"36","author":"Hartman E","year":"2025","journal-title":"J Neurosurg Pediatr."},{"issue":"4","key":"e_1_2_11_3_1","first-page":"324","article-title":"Combined ventral and dorsal rhizotomies for dystonic and spastic extremities","volume":"107","author":"Albright AL","year":"2007","journal-title":"Report of six cases. J Neurosurg."},{"issue":"6","key":"e_1_2_11_4_1","doi-asserted-by":"crossref","DOI":"10.3171\/2024.3.FOCUS2472","article-title":"Nonselective lumbosacral ventral\u2010dorsal rhizotomy for the management of lower\u2010limb hypertonia in nonambulatory children with cerebral palsy","volume":"56","author":"Abdelmageed S","year":"2024","journal-title":"Neurosurg Focus."},{"key":"e_1_2_11_5_1","doi-asserted-by":"crossref","DOI":"10.3389\/fped.2023.1189648","article-title":"Prevalence and related factors of epilepsy in children and adolescents with cerebral palsy: a systematic review and meta\u2010analysis","volume":"11","author":"Gong C","year":"2023","journal-title":"Front Pediatr."},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.3171\/2017.10.PEDS17248"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.3171\/PED\u201007\/07\/032"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0b013e3181c6b257"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.3171\/2023.1.PEDS22368"},{"issue":"6","key":"e_1_2_11_10_1","doi-asserted-by":"crossref","first-page":"571","DOI":"10.3171\/2024.11.PEDS24398","article-title":"Efficacy of selective dorsal rhizotomy in the treatment of spasticity in children with cerebral palsy: a systematic review and meta\u2010analysis","volume":"35","author":"Otero\u2010Luis I","year":"2025","journal-title":"J Neurosurg Pediatr."},{"issue":"4","key":"e_1_2_11_11_1","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1111\/j.1469-8749.1997.tb07414.x","article-title":"Development and reliability of a system to classify gross motor function in children with cerebral palsy","volume":"39","author":"Palisano R","year":"1997","journal-title":"Dev Med Child Neurol."},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/dmcn.70149"},{"issue":"3","key":"e_1_2_11_13_1","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1227\/NEU.0000000000001271","article-title":"Combined Anterior and Posterior Lumbar Rhizotomy for Treatment of Mixed Dystonia and Spasticity in Children With Cerebral Palsy","volume":"79","author":"Abdel Ghany WA","year":"2016","journal-title":"Neurosurgery."},{"issue":"1","key":"e_1_2_11_14_1","doi-asserted-by":"crossref","first-page":"102","DOI":"10.3171\/2020.6.PEDS20295","article-title":"Conus\u2010level combined dorsal and ventral lumbar rhizotomy for treatment of mixed hypertonia: technical note and complications","volume":"27","author":"Ahluwalia R","year":"2021","journal-title":"J Neurosurg Pediatr."},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1227\/ons.0000000000001671"},{"issue":"6","key":"e_1_2_11_16_1","doi-asserted-by":"crossref","first-page":"597","DOI":"10.3171\/2019.12.PEDS19372","article-title":"Intraoperative electrophysiology during single\u2010level selective dorsal rhizotomy: technique, stimulation threshold, and response data in a series of 145 patients","volume":"25","author":"De Vloo P","year":"2020","journal-title":"J Neurosurg Pediatr."},{"issue":"2","key":"e_1_2_11_17_1","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1093\/ptj\/67.2.206","article-title":"Interrater reliability of a modified Ashworth scale of muscle spasticity","volume":"67","author":"Bohannon RW","year":"1987","journal-title":"Phys Ther."},{"issue":"6","key":"e_1_2_11_18_1","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1111\/j.1469-8749.1999.tb00626.x","article-title":"Reliability and responsiveness of the Barry\u2010Albright Dystonia Scale","volume":"41","author":"Barry MJ","year":"1999","journal-title":"Dev Med Child Neurol."},{"issue":"10","key":"e_1_2_11_19_1","doi-asserted-by":"crossref","first-page":"804","DOI":"10.1111\/j.1469-8749.2006.tb01227.x","article-title":"Initial development and validation of the Caregiver Priorities and Child Health Index of Life with Disabilities (CPCHILD)","volume":"48","author":"Narayanan UG","year":"2006","journal-title":"Dev Med Child Neurol."},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.880040610"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.880150603"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1179\/016164104225013806"}],"container-title":["Developmental Medicine &amp; Child Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dmcn.70456","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/dmcn.70456","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dmcn.70456","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T04:31:13Z","timestamp":1789187473000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/dmcn.70456"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,11]]},"references-count":21,"alternative-id":["10.1111\/dmcn.70456"],"URL":"https:\/\/doi.org\/10.1111\/dmcn.70456","archive":["Portico"],"relation":{},"ISSN":["0012-1622","1469-8749"],"issn-type":[{"value":"0012-1622","type":"print"},{"value":"1469-8749","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,11]]},"assertion":[{"value":"2026-02-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-02","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-11","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"dmcn.70456"}}