EFFICACY OF SINGLE STAGE MULTILEVEL SOFT
TISSUE RELEASE BY
PERCUTANEOUS NEEDLE TECHNIQUE FOR SPASTIC
CONTRACTURES OF LOWER LIMBS IN CEREBRAL
PALSY
1 | King Saud University |
Online publication date: 2018-05-17
Publication date: 2018-05-17
Eurasian J Anal Chem 2018;13(3):emEJAC04027
KEYWORDS
ABSTRACT
Background: Single-stage multi-level percutaneous tenotomy and tendon lengthening using
scalpel is a frequently used procedure in lower limbs for spastic cerebral palsy (CP). This study
was performed to assess the outcome of single-stage multilevel percutaneous needle tenotomy
and tendon lengthening among CP patients. Methods: A retrospective study was performed to
analyze the data of all patients who were known to have Cerebral palsy and underwent
percutaneous needle muscle-tendon surgery at authors’ institute during the period between
January 2005 and January 2012. We excluded patients with extrapyramidal system
involvement, those requiring bony correction or taking anti-spasticity therapy and cases with
incomplete information. All patients were followed up regularly for at least 4 years. Results:
There were 174 patients, 98 males (56.3%) and 76 females (43.7%). The mean age at time of
surgery was 7.4 years ± 3.1 (range, 2 to 13). There was no major complications. Minor
bleedings were reported in 39 patients (22.4%). 97 patients had hip affection. Recurrence of
hip adduction deformity occurred in 19 patients (19.6%). Fixed flexion deformity of the knee
was managed in 152 patients. Recurrence of deformity occurred in 47 knees (16.7%).
Hyperextension or recurvatum deformity occurred in 14 knees (5%). There was equinus
deformity of the ankle in 135 patients. Recurrence of equinus occurred in 33 ankles (13%).
The postoperative improvement of hip, knee and ankle motions was found significant
statistically (p< 0.0001) at final follow up. Conclusion: Percutaneous needle tenotomy and
tendon lengthening proved to be safe and effective minimally invasive surgical approach for
spastic contractures in the lower limbs. Our results support using this technique when
performing single stage multilevel surgical releases in CP patients to achieve improvement in
function and hygiene.