Gait & posture · 2026
Impact of single-event multilevel surgery on gait in children with cerebral palsy: A retrospective study.
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Knaepen Clara, Otlet Virginie, Detrembleur Christine, Docquier Pierre-Louis, Stoquart Gaëtan
Аннотация
BACKGROUND: Cerebral palsy (CP) is the leading cause of physical disability in childhood and is often associated with musculoskeletal deformities impairing gait and mobility. While single-event multilevel surgery (SEMLS) is considered the standard approach to correct these deformities, most studies have focused on overall kinematic measurements.
RESEARCH QUESTION: This study aimed to evaluate the specific effectiveness of SEMLS on gait kinematics, mechanical work and energy cost in CP children.
METHODS: Thirty-seven CP children (mean age 13 ± 3 years, GMFCS I-III) who underwent SEMLS between 2002 and 2022 were included in this retrospective study. All patients had pre- and 1-year post-operative 3D gait analyses. Key kinematic variables were selected to assess the different levels addressed by surgery, that changed from child to child. Mechanical and energetic variables were also assessed. Pre- and post-operative data were compared using paired statistical tests (p ≤ 0.05).
RESULTS: Ankle kinematics improved by 17° in dorsiflexion (p < 0.001) in children with equinus. In children with crouch gait, knee extension improved by 13° (p = 0.002). When a femoral derotation osteotomy was performed, hip rotation improved by 12° (p < 0.001). No significant changes were found in mechanical work or energy cost.
SIGNIFICANCE: SEMLS resulted in significant improvements in gait kinematics in CP children, confirming its global effectiveness across multiple surgical levels. However, no significant impact was found on mechanical work or energy cost. Further follow-up is needed to determine whether the benefits of SEMLS in CP children are sustained or evolve over time.
RESEARCH QUESTION: This study aimed to evaluate the specific effectiveness of SEMLS on gait kinematics, mechanical work and energy cost in CP children.
METHODS: Thirty-seven CP children (mean age 13 ± 3 years, GMFCS I-III) who underwent SEMLS between 2002 and 2022 were included in this retrospective study. All patients had pre- and 1-year post-operative 3D gait analyses. Key kinematic variables were selected to assess the different levels addressed by surgery, that changed from child to child. Mechanical and energetic variables were also assessed. Pre- and post-operative data were compared using paired statistical tests (p ≤ 0.05).
RESULTS: Ankle kinematics improved by 17° in dorsiflexion (p < 0.001) in children with equinus. In children with crouch gait, knee extension improved by 13° (p = 0.002). When a femoral derotation osteotomy was performed, hip rotation improved by 12° (p < 0.001). No significant changes were found in mechanical work or energy cost.
SIGNIFICANCE: SEMLS resulted in significant improvements in gait kinematics in CP children, confirming its global effectiveness across multiple surgical levels. However, no significant impact was found on mechanical work or energy cost. Further follow-up is needed to determine whether the benefits of SEMLS in CP children are sustained or evolve over time.