Pediatric Rhizotomy

What is pediatric rhizotomy?
Pediatric rhizotomy, more commonly called selective dorsal rhizotomy (SDR), is a surgery that relieves the muscle tightness or stiffness (spacticity) caused by spastic cerebral palsy.

What is spasticity?
Spasticity is a condition in which muscles are continuously contracted and resist being stretched out. The contraction causes stiffness or tightness that can interfere with movement, speech and walking. Spasticity is usually caused by damage to the portion of the brain or spinal cord that controls voluntary movement. It sometimes occurs with spinal cord injury, multiple sclerosis, cerebral palsy, head injury and metabolic diseases.

Some people with spacticity experience only mild stiffness, while others have severe, painful and uncontrollable muscle spasms.

Who can benefit from SDR?
Selective dorsal rhizotomy is for children with cerebral palsy who have muscle tightness that interferes with movement. There are two groups of children who may benefit from SDR:

• Spastic diplegics - These children can often walk a little bit by themselves. The surgery can help improve leg function, allowing for a smoother, more upright way of walking.
• Severe spastic quadriparetics - These children have spacticity in their arms and legs, and have very limited ability to move. Following surgery they may be able to sit for longer periods of time and power an electric wheelchair. The reduced muscle tension can also make daily care easier for parents.

The multi-disciplinary spine team at Le Bonheur Children's Medical Center can perform an extensive evaluation to determine whether your child can benefit from SDR.

How does SDR work?
During the SDR procedure, a neurosurgeon cuts abnormal sensory nerve roots that carry messages from the leg muscles to the spinal cord. This allows the contracted muscles to relax and become more flexible.

Is SDR permanent?
For patients with spastic diplegia, the results of SDR are usually permanent. In patients with spastic quadriplegia, spasticity can come back, but it's usually less severe than before the operation.

SDR reduces spasticity in the legs. Children who have cerebral palsy might still have spasticity in their arms or hands. SDR is not a cure for cerebral palsy and it doesn't correct deformities, weakness, impaired balance, poor motor control or other problems associated with cerebral palsy.

What's recovery like?
Your child will most likely spend several days in the hospital. Physical therapy and strength training will begin a few days after the surgery and will last for several months.  Medication may be given for pain.

Why Le Bonheaur Children's?
The spine team at Le Bonheur Children's Medical Center are some of the most well respected pediatric surgeons in the United States. The hospital's spine program is dedicated to the treatment and research of pediatric spinal conditions. Children from across the country visit Le Bonheur each year for treatment.