{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T08:57:30Z","timestamp":1782377850958,"version":"3.54.5"},"reference-count":54,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,9,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Selective dorsal rhizotomy (SDR) is a neurosurgical procedure to reduce spasticity in the lower extremities of children with cerebral palsy (CP). The aim of this study was to evaluate gait 30 years after SDR in a prospectively studied cohort to provide clinicians and parents\/caregivers with information about the long-term outcomes of this surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>This cohort was assessed preoperatively with 2D gait analysis in 1985 and followed up at 1 and 3 years postoperatively (short-term outcomes) and at 10, 20, and 30 years postoperatively (long-term outcomes). In the current study, these 2D data were reinforced with 3D gait analysis, including gait graphs, 17 kinematic parameters, and Gait Deviation Index (GDI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Twelve adults with a mean (SD) age of 37.5 (3.3) years with spastic diplegic CP (Gross Motor Function Classification System levels I, II, and III in 4, 6, and 2 patients, respectively) who showed changes in the 2D gait parameters in the short term demonstrated stabilization of hip and knee range of motion and nondimensional temporal distance parameters in the long term (20\u201330 years), while hip and knee midrange values approached normative values. Although 3D gait analysis showed some abnormal parameters, 9 of the 17 kinematic parameters were within the normal range with a mean (SD) GDI of 73.6 (14.4).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>The reduction in lower extremity muscle tone demonstrated on short-term follow-up was sustained in the long term, with some gait parameters approaching the norm in adulthood. Thirty years after SDR, adults with CP walked with a mild crouch gait and no signs of spasticity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2025.3.peds24520","type":"journal-article","created":{"date-parts":[[2025,6,20]],"date-time":"2025-06-20T21:44:13Z","timestamp":1750455853000},"page":"343-352","source":"Crossref","is-referenced-by-count":1,"title":["A prospective gait follow-up study 30 years after selective dorsal rhizotomy"],"prefix":"10.3171","volume":"36","author":[{"given":"Nelleke G.","family":"Langerak","sequence":"first","affiliation":[{"name":"Neuroscience Institute Division of Neurosurgery, Department of Surgery, Faculty of Health Sciences, University of Cape Town, South Africa;"},{"name":"Department of Research, Sint Maartenskliniek, Nijmegen, The Netherlands;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher L.","family":"Vaughan","sequence":"additional","affiliation":[{"name":"Division of Biomedical Engineering, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, South Africa;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. Graham","family":"Fieggen","sequence":"additional","affiliation":[{"name":"Neuroscience Institute Division of Neurosurgery, Department of Surgery, Faculty of Health Sciences, University of Cape Town, South Africa;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Warwick J.","family":"Peacock","sequence":"additional","affiliation":[{"name":"Surgical Science Laboratory, Department of Surgery, University of California, Los Angeles, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shane E.","family":"Brassell","sequence":"additional","affiliation":[{"name":"Neuroscience Institute Division of Neurosurgery, Department of Surgery, Faculty of Health Sciences, University of Cape Town, South Africa;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom F.","family":"Novacheck","sequence":"additional","affiliation":[{"name":"Gillette Children\u2019s Specialty Healthcare, St. Paul;"},{"name":"Department of Orthopedic Surgery, University of Minnesota, St. Paul, Minnesota;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes M. N.","family":"Enslin","sequence":"additional","affiliation":[{"name":"Neuroscience Institute Division of Neurosurgery, Department of Surgery, Faculty of Health Sciences, University of Cape Town, South Africa;"},{"name":"Paediatric Neurosurgery Unit, Red Cross War Memorial Children\u2019s Hospital, Cape Town, South Africa; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert P.","family":"Lamberts","sequence":"additional","affiliation":[{"name":"Department of Human Movement Sciences, University Medical Center Groningen, University of Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"1","key":"b1","series-title":"Neurotherapeutics","first-page":"3","article-title":"The evolution of selective dorsal rhizotomy for the management of spasticity","volume":"16","author":"Enslin JMN","year":"2019","unstructured":"Enslin JMN, Langerak NG, Fieggen AG. The evolution of selective dorsal rhizotomy for the management of spasticity. Neurotherapeutics. 2019;16(1):3\u20138."},{"issue":"11","key":"b2","series-title":"JBJS Rev","first-page":"e3","article-title":"Selective dorsal rhizotomy for the treatment of gait dysfunction in cerebral palsy: a critical analysis review","volume":"7","author":"Chen BP","year":"2019","unstructured":"Chen BP, Wang KK, Novacheck TF. Selective dorsal rhizotomy for the treatment of gait dysfunction in cerebral palsy: a critical analysis review. JBJS Rev. 2019;7(11):e3."},{"issue":"10","key":"b3","series-title":"Ont Health Technol Assess Ser","first-page":"1","article-title":"Lumbosacral dorsal rhizotomy for spastic cerebral palsy: a health technology assessment","volume":"17","author":"Health Quality Ontario","year":"2017","unstructured":"Health Quality Ontario. Lumbosacral dorsal rhizotomy for spastic cerebral palsy: a health technology assessment. Ont Health Technol Assess Ser. 2017;17(10):1\u2013186."},{"issue":"2","key":"b4","series-title":"Curr Neurol Neurosci Rep","first-page":"3","article-title":"State of the evidence traffic lights 2019: systematic review of interventions for preventing and treating children with cerebral palsy","volume":"20","author":"Novak I","year":"2020","unstructured":"Novak I, Morgan C, Fahey M,  State of the evidence traffic lights 2019: systematic review of interventions for preventing and treating children with cerebral palsy. Curr Neurol Neurosci Rep. 2020;20(2):3."},{"issue":"9","key":"b5","series-title":"Childs Nerv Syst","first-page":"1985","article-title":"Long term outcome of selective dorsal rhizotomy for the management of childhood spasticity-functional improvement and complications","volume":"36","author":"Tu A","year":"2020","unstructured":"Tu A, Steinbok P. Long term outcome of selective dorsal rhizotomy for the management of childhood spasticity-functional improvement and complications. Childs Nerv Syst. 2020;36(9):1985\u20131994."},{"issue":"8","key":"b6","series-title":"PLoS One","first-page":"e0236783","article-title":"Selective dorsal rhizotomy; evidence on cost-effectiveness from England","volume":"15","author":"Pennington M","year":"2020","unstructured":"Pennington M, Summers J, Coker B,  Selective dorsal rhizotomy; evidence on cost-effectiveness from England. PLoS One. 2020;15(8):e0236783."},{"issue":"5","key":"b7","series-title":"Dev Med Child Neurol","first-page":"561","article-title":"Long-term effects of spasticity treatment, including selective dorsal rhizotomy, for individuals with cerebral palsy","volume":"64","author":"MacWilliams BA","year":"2022","unstructured":"MacWilliams BA, McMulkin ML, Duffy EA,  Long-term effects of spasticity treatment, including selective dorsal rhizotomy, for individuals with cerebral palsy. Dev Med Child Neurol. 2022;64(5):561\u2013568."},{"issue":"5","key":"b8","series-title":"Dev Med Child Neurol","first-page":"554","article-title":"Long-term effects of selective dorsal rhizotomy in children with cerebral palsy: a systematic review","volume":"62","author":"Tedroff K","year":"2020","unstructured":"Tedroff K, Hagglund G, Miller F. Long-term effects of selective dorsal rhizotomy in children with cerebral palsy: a systematic review. Dev Med Child Neurol. 2020;62(5):554\u2013562."},{"key":"b9","series-title":"Prev Med Rep","first-page":"101142","article-title":"Calibration and validation of accelerometry using cut-points to assess physical activity in paediatric clinical groups: a systematic review","volume":"19","author":"Bianchim MS","year":"2020","unstructured":"Bianchim MS, McNarry MA, Larun L,  Calibration and validation of accelerometry using cut-points to assess physical activity in paediatric clinical groups: a systematic review. 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Disabil Rehabil. 2014;36(1):1\u20139."},{"issue":"2","key":"b12","series-title":"Child Care Health Dev","first-page":"382","article-title":"\u2018Wanting no regrets\u2019: parental decision making around selective dorsal rhizotomy","volume":"49","author":"Waite G","year":"2023","unstructured":"Waite G, Chugh D, Cawker S,  \u2018Wanting no regrets\u2019: parental decision making around selective dorsal rhizotomy. Child Care Health Dev. 2023;49(2):382\u2013391."},{"issue":"9","key":"b13","series-title":"J Paediatr Child Health","first-page":"443","article-title":"Informing knowledge translation for selective dorsal rhizotomy: a survey of Australian clinicians and people with lived experience of cerebral palsy","volume":"60","author":"Lewis JA","year":"2024","unstructured":"Lewis JA, Paget SP, Wimalasundera N,  Informing knowledge translation for selective dorsal rhizotomy: a survey of Australian clinicians and people with lived experience of cerebral palsy. 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J Neurosurg. 1991;74(2):178\u2013184."},{"issue":"6","key":"b16","series-title":"J Neurosurg","first-page":"1014","article-title":"Gait before and 10 years after rhizotomy in children with cerebral palsy spasticity","volume":"88","author":"Subramanian N","year":"1998","unstructured":"Subramanian N, Vaughan CL, Peter JC, Arens LJ. Gait before and 10 years after rhizotomy in children with cerebral palsy spasticity. J Neurosurg. 1998;88(6):1014\u20131019."},{"issue":"10","key":"b17","series-title":"Dev Med Child Neurol","first-page":"744","article-title":"Content validity of the expanded and revised Gross Motor Function Classification System","volume":"50","author":"Palisano RJ","year":"2008","unstructured":"Palisano RJ, Rosenbaum P, Bartlett D, Livingston MH. Content validity of the expanded and revised Gross Motor Function Classification System. 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J Child Orthop. 2018;12(5):413\u2013427."},{"key":"b25","series-title":"Gait Posture","first-page":"153","article-title":"Crouch gait or flexed-knee gait in cerebral palsy: is there a difference? A systematic review","volume":"82","author":"O\u2019Sullivan R","year":"2020","unstructured":"O\u2019Sullivan R, Marron A, Brady K. Crouch gait or flexed-knee gait in cerebral palsy: is there a difference? A systematic review. Gait Posture. 2020;82:153\u2013160."},{"issue":"2","key":"b26","series-title":"Gait Posture","first-page":"244","article-title":"Gait status 17-26 years after selective dorsal rhizotomy","volume":"35","author":"Langerak NG","year":"2012","unstructured":"Langerak NG, Tam N, Vaughan CL,  Gait status 17-26 years after selective dorsal rhizotomy. Gait Posture. 2012;35(2):244\u2013249."},{"key":"b27","series-title":"Gait Posture","first-page":"284","article-title":"Gait status 26-35 years after selective dorsal rhizotomy: a 9 year follow up study","volume":"91","author":"Langerak NG","year":"2022","unstructured":"Langerak NG, Veerbeek BE, Fieggen AG, Lamberts RP. Gait status 26-35 years after selective dorsal rhizotomy: a 9 year follow up study. Gait Posture. 2022;91:284\u2013289."},{"issue":"1","key":"b1","series-title":"Neurotherapeutics","first-page":"3","article-title":"The evolution of selective dorsal rhizotomy for the management of spasticity","volume":"16","author":"Enslin JMN","year":"2019","unstructured":"Enslin JMN, Langerak NG, Fieggen AG. The evolution of selective dorsal rhizotomy for the management of spasticity. 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Ont Health Technol Assess Ser. 2017;17(10):1\u2013186."},{"issue":"2","key":"b4","series-title":"Curr Neurol Neurosci Rep","first-page":"3","article-title":"State of the evidence traffic lights 2019: systematic review of interventions for preventing and treating children with cerebral palsy","volume":"20","author":"Novak I","year":"2020","unstructured":"Novak I, Morgan C, Fahey M,  State of the evidence traffic lights 2019: systematic review of interventions for preventing and treating children with cerebral palsy. Curr Neurol Neurosci Rep. 2020;20(2):3."},{"issue":"9","key":"b5","series-title":"Childs Nerv Syst","first-page":"1985","article-title":"Long term outcome of selective dorsal rhizotomy for the management of childhood spasticity-functional improvement and complications","volume":"36","author":"Tu A","year":"2020","unstructured":"Tu A, Steinbok P. 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