Abstract
Cerebral palsy (CP) is a neuro-developmental disorder. Spastic CP is the most common type of CP and is characterized by contractures of the extremities. Selective Percutaneous Myofascial Lengthening (SPML) is a minimally invasive procedure practiced by a handful of physicians in the US, and it decreases contractures and increases the range of motion in individuals with spastic CP. This study wanted to examine if there was an association between CP severity, socioeconomic status, and reoperation rates. This study used electronic medical records (EMR) to include 626 patients with spastic CP who had surgeries between January 2006 and December 2012. The zip codes from the EMR were used to determine the inflation-adjusted mean income and educational qualification (a high school education or higher) of the community via the US Census Bureau. Disease severity before the initial surgery was determined by using the functional mobility scale in the EMR to compute the Gross Motor Function Classification System (GMFCS) level. Then the data was graphed and averages were taken for the reoperation versus the no-reoperation populations, and Student's t-tests were run to determine statistical significance. The data showed that communities with higher education and income tended to reoperate more often. The higher number of reoperations in affluent communities could mean that either more affluent communities are better educated and know the benefits of bringing their children back for reoperation or that they require further education about physical therapy after the initial surgery to decrease the incidence of reoperation. This retrospective study is a level 2 study looking at the socioeconomic and educational backgrounds and disease severity and their association with reoperation rates.
Highlights
Cerebral palsy (CP) is a group of non-progressive permanent disorders that affect movement and are attributed to non-progressive disturbances that occurred in the developing fetal or infant brain
The factor we looked at was the education level of the community, and we found that the reoperation community's education level was higher
This study showed no significant difference between the mean initial preoperation Gross Motor Function Classification System (GMFCS) value in the reoperation and no-reoperation populations
Summary
Cerebral palsy (CP) is a group of non-progressive permanent disorders that affect movement and are attributed to non-progressive disturbances that occurred in the developing fetal or infant brain. CP can be accompanied by other secondary disturbances, such as communication difficulties [1]. Spastic CP can be subcategorized based on the clinical picture and it usually leads to contractures that will need to be surgically released [2]. Selective Percutaneous Myofascial Lengthening (SPML) is one method that is used to release some of the contractures. SPML has many benefits such as being very quick, less invasive, and leading to faster recovery [3]. The Gross Motor Function Classification System (GMFCS) is a standardized tool that categorizes patients with CP on a scale of 1-5 with independent movement being the least at level five
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