Functional evolution 18 months after selective dorsal rhizotomy in a child with bilateral cerebral palsy from Zona da Mata: case report
DOI:
https://doi.org/10.17267/2238-2704rpf.2026.e6494Keywords:
Rhizotomy, Cerebral Palsy, Functioning, Children with Disabilities, Motor Skills, Physical Therapy ModalitiesAbstract
INTRODUCTION: Selective Dorsal Rhizotomy (SDR) is a neurosurgical intervention used to reduce spasticity in children with cerebral palsy (CP). Despite advances, SDR is still not widely disseminated, and the scarcity of reports limits the understanding of its functional impacts. OBJECTIVE: To describe the functional changes in a child with bilateral spastic CP, diplegic type, after SDR combined with physiotherapy. MATERIALS AND METHODS: Case report with longitudinal follow-up for 18 months of a 3-year-8-month-old male child, classified by the Gross Motor Function Classification System (GMFCS) as level III, who underwent SDR and intensive postoperative rehabilitation. Spasticity was assessed using the Modified Ashworth Scale, and functioning using the Gross Motor Function Measure (GMFM-66), preoperatively and every three months after surgery. GMFM-66 scores were analyzed using GMAE-3 software, which allowed for the estimation of Expected Natural Evolution (ENE) as a parameter to interpret gains over time. RESULTS: After surgery, a reduction in spasticity in the lower limbs was observed. In all postoperative assessments, variations in GMFM-66 scores were greater than the ENE, with a significant increase at three months (p<0.05), a period marked by the acquisition of motor skills previously limited by spasticity. CONCLUSION: SDR combined with physiotherapy and family involvement showed a reduction in spasticity and a significant increase in functioning and motor capacity. The child's active participation and parental involvement were key factors for the success of the treatment.
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Copyright (c) 2026 Isabela de Pádua Ruiz, Vanessa Aparecida Dias Chaves, Leonardo Raphael Santos Rodrigues, Júlia de Souza Castilho Silvério , Rayla Amaral Lemos, Paula Silva de Carvalho Chagas
This work is licensed under a Creative Commons Attribution 4.0 International License.
This work is licensed under a Creative Commons Attribution 4.0 International License.
