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lüll Selective dorsal rhizotomy: meta-analysis of three randomized controlled trials McLaughlin J; Bjornson K; Temkin N; Steinbok P; Wright V; Reiner A; Roberts T; Drake J; O'Donnell M; Rosenbaum P; Barber J; Ferrel ADev Med Child Neurol 2002[Jan]; 44 (1): 17-25This study is a comparative analysis and meta-analysis of three randomized clinical trials. Children with spastic diplegia received either 'selective' dorsal rhizotomy (SDR) plus physiotherapy (SDR+PT) or PT without SDR (PT-only). Common outcome measures were used for spasticity (Ashworth scale) and function (Gross Motor Function Measure [GMFM]). Baseline and 9- to 12-month outcome data were pooled (n=90). At baseline, 82 children were under 8 years old and 65 had Gross Motor Function Classification System level II or III disability. Pooled Ashworth data analysis confirmed a reduction of spasticity with SDR+PT (mean change score difference -1.2; Wilcoxonp<0.001). Pooled GMFM data revealed greater functional improvement with SDR+PT (difference in change score +4.0, p=0.008). Multivariate analysis in the SDR+PT group revealed a direct relationship between percentage of dorsal root tissue transected and functional improvement. SDR+PT is efficacious in reducing spasticity in children with spastic diplegia and has a small positive effect on gross motor function.|*Disabled Children[MESH]|*Rhizotomy[MESH]|Cerebral Palsy/*surgery[MESH]|Child[MESH]|Child, Preschool[MESH]|Female[MESH]|Ganglia, Spinal/*surgery[MESH]|Humans[MESH]|Male[MESH]|Motor Skills[MESH]|Randomized Controlled Trials as Topic[MESH]|Treatment Outcome[MESH] |