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Single-level selective dorsal rhizotomy for spastic cerebral palsy
David Graham1, Kristian Aquilina2, Stephanie Cawker3
1Faculty of Medicine, University of Sydney, Sydney, New South Wales, Australia; ; TY Nelson Department of Neurology and Neurosurgery, The Children's Hospital at Westmead, Sydney, Australia.
Journal of Spine Surgery (Hong Kong)
|October 21, 2016
Summary
Selective dorsal rhizotomy (SDR) effectively reduces lower limb spasticity in children with cerebral palsy (CP). This minimally invasive surgical approach, combined with physiotherapy, offers positive outcomes with few complications.
Area of Science:
- Neurosurgery
- Pediatric Neurology
- Rehabilitation Medicine
Background:
- Cerebral palsy (CP) management necessitates a multidisciplinary strategy.
- Selective dorsal rhizotomy (SDR) is a neurosurgical intervention targeting lower limb spasticity in CP.
- Understanding CP epidemiology and SDR's role is crucial for effective treatment.
Approach:
- This review examines the epidemiology of CP and SDR management.
- Focuses on a minimally invasive SDR technique using single-level laminectomy and intraoperative EMG.
- Details patient workup, recovery protocols, and outcome assessment for SDR.
Key Points:
- Minimally invasive SDR with single-level laminectomy and EMG guidance is effective.
- SDR, when integrated with physiotherapy, yields significant spasticity reduction in selected pediatric CP cases.
- The approach is associated with a low complication rate.
Conclusions:
- SDR is a valuable neurosurgical option for managing spasticity in cerebral palsy.
- A multidisciplinary approach integrating SDR and physiotherapy optimizes patient outcomes.
- The discussed minimally invasive SDR technique offers a safe and effective treatment pathway.
