Evidence map›Paper›PMID 29922840›Full record

ArticleInternational orthopaedics2019

Long-term results of multilevel surgery in adults with cerebral palsy.

Cornelia Putz, Ann- Kathrin Blessing, Sarah Erhard, Katharina Fiethen, Andreas Geisbüsch, Mirjam Niklasch, Leonhard Döderlein, Sebastian Immanuel Wolf, Thomas Dreher

Abstract read
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In one paragraph

Article in International orthopaedics, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.7field-weighted citation impact, top 30% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 9 citations in OpenAlex.

  1. Article
  2. Article
  3. Review
  4. [Precise diagnosis and treatment of spastic cerebral palsy].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2019
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 3 institutions in 1 country.

Cornelia PutzPediatric Orthopaedics, Neuroorthopaedics and Foot Surgery, Center for Orthopaedic and Trauma Surgery, Heidelberg University Hospital, Schlierbacher Landstrasse 200a, 69118, Heidelberg, Germany. cornelia.putz@med.uni-heidelberg.de.ORCID http://orcid.org/0000-0001-6711-7180
Ann- Kathrin BlessingDepartment of Trauma and Orthopaedics, BG Trauma Center Ludwigshafen, Ludwig-Guttmann-Strasse 13, 67071, Ludwigshafen, Germany.
Sarah ErhardPediatric Orthopaedics, Neuroorthopaedics and Foot Surgery, Center for Orthopaedic and Trauma Surgery, Heidelberg University Hospital, Schlierbacher Landstrasse 200a, 69118, Heidelberg, Germany.
Katharina FiethenPediatric Orthopaedics, Neuroorthopaedics and Foot Surgery, Center for Orthopaedic and Trauma Surgery, Heidelberg University Hospital, Schlierbacher Landstrasse 200a, 69118, Heidelberg, Germany.
Andreas GeisbüschPediatric Orthopaedics, Neuroorthopaedics and Foot Surgery, Center for Orthopaedic and Trauma Surgery, Heidelberg University Hospital, Schlierbacher Landstrasse 200a, 69118, Heidelberg, Germany.
Mirjam NiklaschPediatric Orthopaedics, Neuroorthopaedics and Foot Surgery, Center for Orthopaedic and Trauma Surgery, Heidelberg University Hospital, Schlierbacher Landstrasse 200a, 69118, Heidelberg, Germany.
Leonhard DöderleinOrthopaedic Hospital for Children, Behandlungszentrum Aschau GmbH, Bernauerstrasse 18, 83229, Aschau im Chiemgau, Germany.
Sebastian Immanuel WolfPediatric Orthopaedics, Neuroorthopaedics and Foot Surgery, Center for Orthopaedic and Trauma Surgery, Heidelberg University Hospital, Schlierbacher Landstrasse 200a, 69118, Heidelberg, Germany.
Thomas DreherPediatric Orthopaedics, Neuroorthopaedics and Foot Surgery, Center for Orthopaedic and Trauma Surgery, Heidelberg University Hospital, Schlierbacher Landstrasse 200a, 69118, Heidelberg, Germany.
Heidelberg University · DEBehandlungszentrum Aschau · DEKlinikum Ludwigshafen · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDeterioration of gait in adolescent and adult patients with cerebral palsy can be associated with multiple factors. Multilevel surgery (MLS) is one option in adults with cerebral palsy to improve gait function with encouraging short-term results. It is a question whether these improvements are maintained over time.

methodsIn a retrospective consecutive cohort study, adults with bilateral spastic cerebral palsy (BSCP) treated with MLS between 1995 and 2011 were scanned for potential inclusion. Patients needed to fulfill the following inclusion criteria: age at MLS > 17, standardized three-dimensional gait analysis (3D-GA) including clinical examination at pre-operative (E0), a short-term follow-up (E1) and at least seven years (E2) after the index MLS. Twenty adults (10 women, 10 men) with a Gross Motor Function Classification Level (GMFCS) I-III and a mean age at MLS of 24.8 years were included in this study. The average long-term follow-up was 10.9 years. The Gait Profile Score (GPS) was used as primary outcome measure.

resultsThe GPS improved significantly from 13.8° before surgery to 11.2° at short-term (p = 0.007) and to 11.3° at long-term follow-up (p = 0.002). Mean GPS showed a slight deterioration between E1 and E2 due to a minority of six patients (30%) who showed a significant loss of correction.

conclusionSurgical treatment in adults with BSCP was feasible and effective in the long-term. Significant improvement of gait and function was maintained in the majority of patients, while some patients were prone to develop crouch gait, hip flexion contractures, or pain.

Indexed as

Cerebral PalsyFemaleFollow-Up StudiesGaitGait Disorders, NeurologicHumansMaleRetrospective StudiesTime FactorsTreatment OutcomeYoung AdultAdultsCerebral palsyGaitMultilevel surgery

Identifiers

PMID29922840
OpenAlexW2809543301

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.