Selective Dorsal Rhizotomy (SDR)
For Spasticity in Cerebral Palsy
Cerebral palsy is a brain condition that affects movement, posture and coordination. It may be seen at or around the time of birth or may not become obvious until early childhood.
Some children will have lower limb spasticity, which can cause problems with walking and sitting, as well as discomfort, cramps and spasms.
Selective Dorsal Rhizotomy is a major surgical procedure that aims to reduce the amount of information carried by the sensory nerves.
With the child under general anaesthetic, a cut is made in the lower back and into the spinal canal to expose the spinal cord and lower nerves.
Some of the sensory nerves that carry information from the muscles in the legs are cut. The nerves that make the muscles contract are not cut.
After the procedure the child will need long-term physiotherapy and aftercare and may have to learn to walk again.
This type of surgery has caused complications in some children, including an unpleasant tingling sensation, like pins and needles, in the part of the body that the removed nerves used to be connected to, constipation, or problems urinating.
You and your child (if they are able to understand the implications of surgery) should discuss the potential benefits and risks of this procedure with your consultant.
Other surgical procedures for spasticity include tendonotomy (cutting of tendons), neurotomy (cutting of nerves), osteotomy (cutting of bones), and tendon lengthening.
Other treatment options include drugs (baclofen, botulinum toxin), use of corrective braces, physiotherapy, and electrical stimulation of the muscles or lower spinal cord.