Surgery to improve walking ability in children with cerebral palsy

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Recent research has discovered a surgical procedure that can improve walking ability in children with cerebral palsy.

The procedure, known as selective dorsal rhizotomy, involves cutting some of the sensory nerves from the legs as they enter the spinal cord in order to relieve stiffness, improve mobility and reduce children's pain levels.

The operation is irreversible, and it had not previously been fully established whether it helped to improve children's quality of life, or what the longer-term effects were.

Because of the lack of evidence of the benefits of the procedure, NHS England established an innovative study that assessed eligible children with cerebral palsy before and after the operation.

Cerebral palsy is the name for a group of lifelong conditions that affect movement and coordination, caused by abnormal development or damage to the brain that occurs before, during or soon after birth.

In the UK around 1,700 children, every year are born with cerebral palsy. Treatments include medicines to relieve muscle stiffness, pain relief, and physiotherapy to aid walking.

The team of researchers was instructed to find out whether selective dorsal rhizotomy did improve outcomes for these children with cerebral palsy.

"NHS England has now decided that this procedure will be funded as a direct result of this innovative project. It's great to get this decision so that it will make a difference to patients," said Janet Peacock, one of the lead researchers of the study.

For the research, five centres were selected to perform selective dorsal rhizotomy, resulting in 137 children receiving the procedure. The researchers then collected and analysed data on patients' progress for two years after their operations.

Their results, published in 'The Lancet Child and Adolescent Health', showed the procedure benefitted children by improving their movement, quality of life and levels of pain. They also found that there were no significant health risks to the children from the procedure.

"This procedure is for children with cerebral palsy who can walk but are having problems because the stiffness in their legs leads to pain and a lack of control over movement. Because it involves cutting nerves, the procedure is irreversible," Peacock explained.

Researchers claim this study shows objectively that the procedure does improve motor function, and doesn't have dangerous side effects. For some children with cerebral palsy and their families, this could really improve the quality of life and help children walk more easily and without the use of walking frames and other aids.

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