Orthopedic Outcomes After Hemispherectomy
Abstract number :
3.327
Submission category :
9. Surgery / 9B. Pediatrics
Year :
2022
Submission ID :
2204548
Source :
www.aesnet.org
Presentation date :
12/5/2022 12:00:00 PM
Published date :
Nov 22, 2022, 05:25 AM
Authors :
Monika Jones, JD – The Brain Recovery Project; Aria Fallah, MD, MS – Director, Pediatric Epilepsy Surgery Program, Neurosurgery, UCLA; Klajdi Puka, PhD – Adjunct Research Professor, Epidemiology and Biostatistics, Western University
Rationale: Little is known about orthopedic outcomes after hemispherectomy. This study evaluates orthopedic outcomes after hemispherectomy in children with epilepsy, and identifies the clinical and demographic variables associated with orthopedic outcomes.
Methods: Data came from the Global Pediatric Epilepsy Surgery Registry, a patient-driven web-based registry which allows parents and guardians of children with epilepsy to report on outcomes after epilepsy surgery. Parents across the world are recruited via email and social media. Parents reported on demographic and clinical characteristics, and orthopedic outcomes, including orthopedic surgeon visits, orthopedic conditions such as hemiplegia, and orthopedic procedures and devices utilized. The impact of side of etiology, age at seizure onset, age at surgery, and years follow-up were considered.
Results: Parents of 154 children (56% male) who had undergone a hemispherectomy participated. Children were aged 1.4 (SD, 2.8) years at seizure onset, 3.4 (SD, 3.5) years at first surgery, and 9.9 (SD, 5.5) years at follow-up; the average follow-up period since last surgery was 5.6 (SD, 4.7) years. At follow-up, 85% were seizure-free. With respect to orthopedic outcomes, 16% had seen an orthopedic surgeon before surgery, which increased to 52% post-surgery. Pre-surgery, 44% presented with orthopedic conditions (e.g., monoplegia, hemiplegia), which increased to 91% post-surgery; hemiplegia was most common. Post surgery, 100% of children had an orthotic procedure or used an orthotic device; 28% reported surgery to muscles, bones, or nerves; and 97% and 80% use an orthotic device for their upper and lower body, respectively. Orthopedic outcomes were similar for those with a left, right, or bilateral etiology (p >.05).
Children who were older at seizure onset and at the time of their hemispherectomy were more likely to have a pre-surgical orthotic condition (p=0.04, and p< .01, respectively). Children followed for a longer period were more likely to see an orthopedic surgeon (p< .01).
Surgery