Selective dorsal rhizotomy is an effective treatment for spasticity in children with cerebral palsy who have a spastic motor disorder. It is hypothesized that muscle shortening is related to spasticity; the lack of stretch of a muscle is thought to be the cause of muscle shortening. If this is true, the treatment for spasticity should prevent the occurrence of muscle shortening during growth. We present the case of 1 child with cerebral palsy and spastic diplegia, for whom the treatment with selective dorsal rhizotomy was successful in improving the walking abilities. She did, however, develop muscle shortening during growth. In conclusion, the development of muscle shortening during growth in children with cerebral palsy and spastic paresis cannot be prevented by treatment for the spasticity alone.
McLaughlin J. , Bjornson K., Temkin N., et al. Selective dorsal rhizotomy: meta-analysis of three randomized controlled trials. Dev Med Child Neurol . 2002;44:17-25.
2.
Steinbok P.Outcomes after selective dorsal rhizotomy for spastic cerebral palsy . Childs Nerv Syst. 2001;17:1-18.
Lance JWThe control of muscle tone, reflexes, and movement: Robert Wartenberg Lecture . Neurology. 1980;30:1303-1313.
5.
Scholtes VA, Becher JG, Beelen A., Lankhorst GJClinical assessment of spasticity in children with cerebral palsy: a critical review of available instruments. Dev Med Child Neurol. 2006;48: 64-73.
6.
Haugh AB, Pandyan AD, Johnson GRA systematic review of the Tardieu Scale for the measurement of spasticity . Disabil Rehabil. 2006;28:899-907.
7.
Graham HK, Harvey A., Rodda J., Nattrass GR, Pirpiris M.The Functional Mobility Scale (FMS). J Pediatr Orthop . 2004;24: 514-520.
8.
Rodda JM, Graham HK, Carson L., Galea MP, Wolfe R.Sagittal gait patterns in spastic diplegia. J Bone Joint Surg Br. 2004;86: 251-258.
9.
Rosenbaum PL , Walter SD, Hanna SE, et al. Prognosis for gross motor function in cerebral palsy: creation of motor development curves . JAMA. 2002;288:1357-1363.
10.
Bell KJ, Ounpuu S., DeLuca PA, Romness MJNatural progression of gait in children with cerebral palsy. J Pediatr Orthop. 2002;22:677-682.
11.
Van Schie PE , Vermeulen RJ, van Ouwerkerk WJ, Kwakkel G., Becher JGSelective dorsal rhizotomy in cerebral palsy to improve functional abilities: evaluation of criteria for selection. Childs Nerv Syst. 2005;21:451-457.
12.
Steinbok P. , Reiner AM, Beauchamp R., Armstrong RW, Cochrane DD, Kestle J.A randomized clinical trial to compare selective posterior rhizotomy plus physiotherapy with physiotherapy alone in children with spastic diplegic cerebral palsy. Dev Med Child Neurol . 1997;39:178-184.
13.
O'Dwyer NJ, Neilson PD, Nash J.Mechanisms of muscle growth related to muscle contracture in cerebral palsy . Dev Med Child Neurol. 1989;31:543-547.
14.
Ziv I., Blackburn N., Rang M., Koreska J.Muscle growth in normal and spastic mice. Dev Med Child Neurol . 1984;26:94-99.
15.
De Deyne PGLengthening of muscle during distraction osteogenesis . Clin Orthop Relat Res. 2002;(403 suppl):S171-S177.
16.
Lieber RL, Friden J.Spasticity causes a fundamental rearrangement of muscle-joint interaction . Muscle Nerve. 2002;25: 265-270.
17.
Friden J., Lieber RLSpastic muscle cells are shorter and stiffer than normal cells. Muscle Nerve. 2003;27:157-164.
18.
Lieber RL, Runesson E., Einarsson F., Friden J.Inferior mechanical properties of spastic muscle bundles due to hypertrophic but compromised extracellular matrix material. Muscle Nerve . 2003;28:464-471.
19.
Booth CM, Cortina-Borja MJ, Theologis TNCollagen accumulation in muscles of children with cerebral palsy and correlation with severity of spasticity. Dev Med Child Neurol . 2001;43: 314-320.
20.
Shortland AP , Harris CA, Gough M., Robinson ROArchitecture of the medial gastrocnemius in children with spastic diplegia. Dev Med Child Neurol. 2001;43:796-801.
21.
Foran JR, Steinman S., Barash I., Chambers HG, Lieber RLStructural and mechanical alterations in spastic skeletal muscle. Dev Med Child Neurol. 2005;47:713-717.
