Title : Parent- reported outcomes following single event multilevel surgery in children with cerebral palsy
Abstract:
Introduction:
Single Event Multilevel Surgery (SEMLS) is a comprehensive approach to addressing musculoskeletal issues in children with cerebral palsy. This study aims to evaluate parental experiences and perceived outcomes following SEMLS in a cohort of 48 patients. We analyzed data on functional improvements, pain reduction, satisfaction levels, and complications. Results indicate significant improvements in mobility, with 57% of patients showing enhanced walking or running abilities. Pain reduction was reported in 86% of cases, and 88% of parents expressed high satisfaction with the outcomes. The study highlights the positive impact of SEMLS on patients quality of life, emphasizing the crucial role of post-operative physiotherapy. While complications were minimal, some patients experienced chronic issues requiring ongoing management. This research provides valuable insights into the efficacy of SEMLS from a parental perspective, supporting its use in the comprehensive management of cerebral palsy.
Methodology:
A cross-sectional descriptive study with a pre- and post-SEMLS procedure approach was conducted. Retrospective data were collected for 48 children with cerebral palsy who underwent Single Event Multilevel Surgery (SEMLS) at our institution. Pre- and post-surgery GMFCS level evaluations were retrieved from medical records, verified through previous orthopedic clinic visits, and confirmed by consultations with the physical therapy department. The impact of SEMLS on social activities and patients’ quality of life was assessed using structured questionnaires completed by parents or primary caregivers.
Results:
Paired sample t test revealed the post-surgery GMFC scores significantly lower than pre-surgery GMFC scores (p=0.00).Patients from younger age group (1-5 years) were reported more improvement in the standing with support (p=0.032) while older age group i.e. 10 or above years were found more in the excellent outcomes in the education (p-0.021). Patients with post Cast physiotherapy were found highly satisfied (p=0.03). Majority of the patients after adductor procedure reported excellent improvement in hygiene (p=0.01). Patients after having hamstring procedure were found significantly improved in Independence and aesthetic (p=0.04 and p=0.01 respectively). Overall emotions or feeling were also improved after hamstring procedures (p=0.053). Pelvic Osteotomy procedure also reported with excellent hygienic improvement (p=0.03).
Conclusion:
This study provides compelling evidence for the effectiveness of Single Event Multilevel Surgery (SEMLS) in improving the functional outcomes and quality of life for children with cerebral palsy. The significant improvements in mobility, substantial reduction in pain levels, and high parental satisfaction rates underscore the value of this surgical approach in managing complex musculoskeletal issues associated with cerebral palsy
