TREATMENT SPECIALISTS AND COMMONLY ASKED QUESTIONS ABOUT SELECTIVE DORSAL RHIZOTOMY
|Dr T.S. Park and young patient
T.S. Park, MD
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What is selective dorsal rhizotomy?
Selective dorsal rhizotomy (SDR) is a neurosurgical procedure that reduces spasticity and provides marked improvement in walking and standing in children or adults who have cerebral palsy. Our neurosurgeons have developed surgical techniques that allow us to perform SDR with only a limited removal of bone from the spine.
What is the Washington University advantage?
At Washington University, our neurosurgeons have been performing SDR on patients with cerebral palsy since 1990. They have performed selective dorsal rhizotomy on more than 1000 patients - more than anywhere in the country
We believe our procedures offer significant benefit over others, in terms of reduced risk of spinal deformities in later years, decreased post operative motor weakness, reduced hip flexor spasticity by sectioning the first lumbar dorsal root, shorter-term and less intense back pain.
Our current opinion is that most patients with spastic diplegia or quadriplegia should have spasticity reduced first through SDR before undergoing muscle or tendon release procedures.
Who can benefit from this procedure?
Not all patients with spastic cerebral palsy benefit from selective dorsal rhizotomy SDR). At our Center, patients are selected for the surgery on the basis of the following criteria and considerations.
Essential criteria for children under 18 years of age:
- Diagnosis of spastic diplegia or spastic quadriplegia
- History of premature birth; if born at full term, child must have typical signs of spastic diplegia
- No severe damage to the basal ganglia on MRI examination
- Patients exhibit potential for improvement in functional skills after dorsal rhizotomy
Essential criteria for adults between 19 and 45 years of age:
- Diagnosis of spastic diplegia
- History of premature birth
- Currently walks independently without assistive device
- Relatively mild fixed orthopedic deformities
- Patients exhibit potential for functional gains after dorsal rhizotomy
- Patients exhibit motivation to attend physical therapy and perform home exercise program
We recently began to perform dorsal rhizotomy in adult patients on the basis of our accumulated experience with the procedure on pediatric patients. To date, we have observed satisfactory functional gains in adult patients that are similar to those in children.
How do I get more information?
For more information, interactive correspondence and full Questions and Answers, please visit the web site of the Center for Cerebral Palsy Spasticity. This site will provide you pictures of the operations, list the risks and benefits and introduce you to members of the team.