Functional analysis of Single Event Multilevel Surgery (SEMLS) for Cerebral Palsy (CP) children in Southern Andhra Pradesh

Background: Orthopaedic Surgery (OS) in Cerebral Palsy (CP) children plays important role to improve function, correct and prevent deformities. It is one of the most frequent causes of motor disability of children due to brain lesion in developing foetus or infant. The incidence is 2 to 3 cases as in 1000 live births. Aims and Objectives: The aim of surgical intervention is to address all the deformities simultaneously by simple, single stage surgical procedures. During the past 3 decades correction of all fixed musculoskeletal deformities by Single Event Multilevel Surgery (SEMLS) has been popularized and advocated in many paediatric orthopaedic surgical centres. SEMLS improves walking balance, early mobilization, reduces the need for repeated hospitalization. Study design and methods: This prospective study started in September 2023. CP children from 5 to 8 years age are included. SEMLS procedures are performed for 40 children. 25 are female and 15 are male. The Gross Motor Function Classification System (GMFCS) [4] and International Classification of Functioning, Disability and Health Child (ICFDHC) [12] are followed for clinical evaluation, surgical planning and to evaluate the results. Results: The functional improvement as per GMFCS noticed after 12-24 months (avg 18 months). There were 25 children (62.5%) excellent, 10 (25%) good results and 5(12.5%) children got poor results. Conclusion: Single event multilevel soft tissue surgery in the lower limbs yields good results for locomotion. There is improved personal hygiene in cases of bilateral adductor spastic contractors.