What is Selective Dorsal Rhizotomy?
Selective Dorsal Rhizotomy (SDR) is a neurosurgical procedure aimed at reducing spasticity in patients with cerebral palsy. This technique involves cutting some of the sensory nerve fibers that come from the muscles and enter the spinal cord. The goal is to reduce the overactivity in these nerves, which can help improve mobility and reduce discomfort.
How is SDR Performed?
The procedure is typically performed under general anesthesia. A neurosurgeon makes an incision in the lower back to access the
spinal cord. Using intraoperative monitoring, the surgeon identifies and cuts the specific nerve roots that are contributing to muscle spasticity. The entire process usually takes a few hours and is followed by a recovery period in the hospital.
Who is a Candidate for SDR?
SDR is generally considered for children who have spastic diplegia or quadriplegia due to
cerebral palsy. Ideal candidates are typically between the ages of 3 to 10 years and have spasticity that affects their quality of life and mobility. It is crucial for candidates to have good underlying muscle strength and the ability to participate in intensive post-operative
physical therapy.
What are the Benefits of SDR?
The primary benefit of SDR is the reduction of spasticity, which can lead to improved mobility and function. Many children experience better balance, increased range of motion, and reduced pain. These improvements can make activities of daily living easier and allow for more effective participation in physical therapy and other rehabilitation programs.
What are the Risks and Limitations?
As with any surgical procedure, SDR carries risks, including infection, bleeding, and complications related to anesthesia. There is also a risk that the surgery may not produce the desired outcomes, or that spasticity could return over time. Additionally, SDR requires a significant commitment to post-operative rehabilitation, which can be demanding for both the child and their family.
Post-Operative Care
Following SDR, children typically need to stay in the hospital for about a week. Intensive physical therapy begins immediately and continues for several months to a year. The goal of therapy is to strengthen muscles, improve coordination, and maximize functional gains. Ongoing follow-up with the medical team is essential to monitor progress and address any complications.Conclusion
Selective Dorsal Rhizotomy can offer significant benefits for children with spasticity due to cerebral palsy, particularly when other treatments have not been effective. While it is not a cure for the underlying causes of neonatal disorders, SDR can dramatically improve the quality of life and functional abilities of affected children. Families considering this procedure should consult with a multidisciplinary team to determine the best course of action for their child's specific needs.
