Combined dorsal and ventral rhizotomy in non-ambulatory individuals with mixed spastic bilateral cerebral palsy: A prospective registry analysis.

Aim

To establish the efficacy of combined dorsal and ventral rhizotomy (CDVR) and associated quality of life (QoL) changes in individuals with cerebral palsy (CP).

Method

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-Albright Dystonia Scales at 3 months and 12 months after surgery. QoL was measured using the Caregiver Priorities and Child Health Index of Life with Disabilities.

Results

Thirty-three patients (21 males, 12 females) underwent CDVR between 2020 and 2025 at an average age of 14 years 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 months by a median of 2 levels (preoperative: 3.0 [3.0-4.0] vs 1.0 [1.0-1.25] at 1 year, p < 0.001). Dystonia improved at 12 months (preoperative: 17.5 [10.0-21.25] vs 8.0 [3.25-10.5] at 12 months, p = 0.016). The Caregiver Priorities and Child Health Index of Life with Disabilities scores indicated improved QoL at 12 months (33.8 [5.3] vs 48.1 [4.7], p = 0.012). All patients returned to their stander or gait assistive devices by 1 year.

Interpretation

CDVR is safe and effective in non-ambulatory individuals with bilateral, mixed spastic-dyskinetic CP and improves QoL without decreasing preoperative function.