Case of the week - 9/2/99

from The Hong Kong Polytechnic University & Tuen Mun Child Assessment Centre, Hong Kong

A case of Spastic Diplegia analysed pre & post-Selective Posterior Rhizotomy 

 

 
 
 
 
 
 
 
 
 
 
 

This case of spastic diplegia was analysed before, immediately post-op, 6 months post-op, and 18 months post-op following a Selective Posterior (Dorsal) Rhizotomy procedure in April 1998. She had had no previous surgery, and is now 12 y old.
 
 
 

Analysis of the first three occassions was done with 2D videography - the most recent study was done using Vicon 370 3D motion capture.
 
 

She has complained of lumbar back pain since the operation, worse on walking.
 
 
 
 
 
 
 
 
 

Summary Table

Study
Pre-op 7/97
Post-op 5/98
6 mo. 1/98
18 mo. 1/99
Variable %
pred.		 % 
pred.		 % pred. % pred.
Cadence (steps/min) 97 75 83 64
103
 87
89
 70
Stride Length (m) 0.9  74 0.5 41 1.3 91 0.88 72
Velocity (m/s) 0.7  57  0.3 27 1.1 81 0.66 52
Right Right Right Left Right Left
Max. plantarflexion (degrees)
12.6
2.9
 20 21 6.5 4
Max. plantarflexion velocity (deg/s)
42 
 126 108 170 260 62
Max. knee swing flexion (degrees)
52
56
 61 58 63 45
Max. knee extension (degrees) 12 14 12 9 10 11
Max. hip extension (degrees)
-3
8
 3.5 -5 11 16
 

Movies(PC users get the QuickTime plug-ins here - right mouse-click "Save Link as..." - Windows 95/NT and 3.1)

The movies will open in new browser windows so you can view them simultaneously with analysis.
Note: the 2D earlier movies were recorded for optimal visibility of reflective markers in 2D videography, and so are rather dark.
 
 
Pre-op
 Immed. Post-op Post-op 6 mo. 18 mo. Post-op
movie format QuickTime QuickTime QuickTime QuickTime
  right view front view right view right view
  left view left view left view left view

Post-op Gait Analysis results at 18 months

left joint kinematics & kinetics left arm powers (QuickTime 1.1Mb)
right joint kinematics & kinetics right arm powers (QuickTime 1.1Mb)

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Case prepared by Dr. Chris Kirtley & referred by Beverly Yiu

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Maintained by DDr. Chris Kirtley, Andreas Kranzl
Last modified on Wednesday, 9-Feb. 1999.

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