Botulinotherapy and Orthopedic Interventions After Selective Dorsal Rhizotomy in Children with Cerebral Palsy: Cohort Study
Why this work is in the frame
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Bibliographic record
Abstract
Background . Selective dorsal rhizotomy (SDR) is an effective neurosurgical method for reducing spasticity in children with cerebral palsy (CP). The need for other medical (anti-spastic) and surgical treatment methods after SDR remains poorly studied. Objective . Aim of the study is to evaluate the frequency of using botulinum therapy and orthopedic interventions, as well as target muscles selection for injection in patients with cerebral palsy after SDR. Methods . Prospective cohort study included patients under the age of 18 years after SDR performed between January 2021 and June 2023. Frequency, timing, target muscles for botulinotherapy, oral anti-spastic drugs administration, as well as frequency, timing, and type of orthopedic surgeries (year after rehabilitation due to performed SDR) were determined via interviewing (remote or face-to-face) of patients’ legal representatives. Results . The study included data from 107 children with spastic cerebral palsy (GMFCS I — 2, GMFCS II — 14, GMFCS III — 68, GMFCS IV — 22, GMFCS V — 1) who underwent SDR at median age of 5.0 (3.9; 6.9) years. The follow-up period after SDR was 12–41 months, median was 20.8 (16.5; 26.7) months. Botulinotherapy was performed in 24 (22.4%) patients (4 for the first time) after SDR, the initiation period was 1.5–36 months after SDR, the median was 10.7 (6.9; 16.4) months. Injections were performed only in the arm’s muscles in 4 children, only in leg’s muscles — in 10, in upper and lower limbs — in 10, in salivary glands — in 1 case. Orthopedic surgeries were performed in 26 (24.3%) cases 3.5–34 months after SDR, median — 14.8 (8.0; 22.6) months. Procedures on soft-tissues of lower limbs were performed in 17 patients, 9 patients had combined soft tissue and bone surgery. Age at surgery was 3.3–12.7 years, median age — 5.9 (5.0; 8.5) years. Oral myorelaxant administration after SDR (continued) was reported only in one patient. Conclusion . Some patients with cerebral palsy require implementation of other methods for spasticity and orthopedic deformities correction even after SDR due to the child growth.
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Direct model labels (unvalidated)
Per-model category and study-design labels from the labeling rounds. They are machine output, unvalidated, and the disagreement between models ships as data. No study design here is MEDLINE-validated yet.
| Model arm | Categories | Study design | Confidence |
|---|---|---|---|
| gemma | no category Domain: not available · Genre: Empirical About the Canadian research system: no · About a Canadian topic: no | Observational | low |
| gpt | no category Domain: not available · Genre: Empirical About the Canadian research system: no · About a Canadian topic: no | Observational | medium |
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it