Skip to content

What is Selective Dorsal Rhizotomy?

What is Selective Dorsal Rhizotomy?

Selective Dorsal Rhizotomy (SDR) is a surgical procedure performed on children with Cerebral Palsy. There are many variations but often a child with cerebral palsy would have severe stiffness (spasticity) in their lower limbs making walking difficult or impossible. Selective dorsal rhizotomy aims to reduce the amount of information carried by the sensory nerves and therefore reduce or remove the spasticity.

The operation involves opening a vertabrae of the spinal column to expose the spinal cord and lower nerves. Then, sectioning (cutting) of some of the sensory nerve fibres that come from the muscles and enter the spinal cord takes place. The neurosurgeon divides each of the dorsal roots into rootlets which are then stimulated electrically using electromyography. The sensory rootlets that are seen to cause spasticity are then selectively cut, which leaves the normal rootlets intact. The motor nerve rootlets also remain untouched. This results in reduction of the spasticity whilst preserving sensation and movement of the limbs.

After surgery, children are incredibly weak and have residual muscle tightness. Regular postoperative physiotherapy is an essential part of the procedure and to obtain the best results children and families need to be motivated to cooperate with intensive therapy. Current NICE guidelines state that physiotherapy should be carried out at least three times a week for the first four months, gradually reducing to once a month at two years post-surgery.

Selective Dorsal Rhizotomy

To book an assessment or for more information please email call 0161 883 0066 .