Combined dorsal and ventral rhizotomy in non-ambulatory individuals with mixed spastic bilateral cerebral palsy: A prospective registry analysis.

AIM: To establish the efficacy of combined dorsal and ventral rhizotomy (CDVR) and associated quality of life (QoL) changes in individuals with cerebral palsy (CP).

METHOD: This was a prospective and consecutive recruitment of patients undergoing CDVR analyzed using retrospective cohort analysis. Spasticity and dystonia were measured using the modified Ashworth and Barry-Albright Dystonia Scales at 3 months and 12 months after surgery. QoL was measured using the Caregiver Priorities and Child Health Index of Life with Disabilities.

RESULTS

Thirty-three patients (21 males, 12 females) underwent CDVR between 2020 and 2025 at an average age of 14 years 6 months; 91% were classified in Gross Motor Function Classification System level V. CDVR had a low complication rate (one wound infection and no cerebrospinal fluid leaks). Spasticity was improved in all patients at 12 months by a median of 2 levels (preoperative: 3.0 [3.0-4.0] vs 1.0 [1.0-1.25] at 1 year, p < 0.001). Dystonia improved at 12 months (preoperative: 17.5 [10.0-21.25] vs 8.0 [3.25-10.5] at 12 months, p = 0.016). The Caregiver Priorities and Child Health Index of Life with Disabilities scores indicated improved QoL at 12 months (33.8 [5.3] vs 48.1 [4.7], p = 0.012). All patients returned to their stander or gait assistive devices by 1 year.

INTERPRETATION: CDVR is safe and effective in non-ambulatory individuals with bilateral, mixed spastic-dyskinetic CP and improves QoL without decreasing preoperative function.