Is Spine Surgery in Patients with Cerebral Palsy Regarded as Worthwhile?

Introduction: Spine surgery in patients with cerebral palsy is very controversial as to the functional benefits to the child and family.

Methods: All cerebral palsy patients fused between 1/1/80 and 12/31/95 were identified. The family and/or caretakers were sent a survey eliciting their opinion of the child’s functional changes following surgery, rating the function as either better, no change or worse compared to the function before surgery. Of the 166 patients operated on in these 15 years, 11 could not be located and 47 questionnaires were not returned. Of the 108 surveys returned, 16 were not completed, as the current caretaker had no knowledge of the pre-operative status. Of the 92 completed surveys, 68 were completed by a parent.

Results: In the majority of the cases there was an improvement in the comfort level of the child and greater ease of positioning (89%), in physical endurance (67%) and in pulmonary status (60%). Most cases did not have a change in selfcare abilities (77%), activity (61%), awareness or communication (69%). The number of patients better was similar to the number of patients with no change for emotional status, nursing care, feeding or eating, and transportation. In reply to the question whether they would agree to surgery again, 85 (92%) of the respondents replied yes, 3 replied no, and four were either undecided or did not answer the question.

Summary: Family and caregivers of patients with cerebral palsy note functional benefits in the patient following spine fusion surgery. Most (92%) would agree to surgery again.