Multi-Level Fibrotomy for Pediatric Patients with Cerebral Palsy: A Cohort Study

Abstract

Muscle retraction in Cerebral Palsy (CP) often requires surgical treatment. Multilevel procedures (using open or percutaneous techniques) are commonly performed in the ambulant patient with CP. The necessity to find new surgical techniques, reduce postoperative discomfort, and accelerate the healing process and rehabilitation is mandatory for these patients. A retrospective cohort study with 189 pediatric patients with CP was performed. The multilevel gradual fibrotomy of Ulzibat was modified using an ophthalmic knife. No significant complications were reported using our technique. Opioid drugs were not necessary, and casting time was reduced at the first 24 h. A significant Range of Motion recovery was assessed post-operatory and maintained at the last follow-up. Mean days of hospitalization were 2.2. The mean follow-up was 39 months (6–64 months). The modified multilevel fibrotomy reduces postoperative pain with easier patient management, resulting in a faster discharge from the hospital. However, the retrospective nature and the lack of a control group of the present study did not allow the authors to report significant results. Further studies with longer follow-up are in progress to obtain more certain data that confirm our preliminary results.