The selective dorsal rhizotomy technique for spasticity in 2020: a review

Area of Science:

• Neurosurgery
• Pediatric Orthopedics
• Rehabilitation Medicine

Background:

• Spasticity in children significantly impacts motor function and quality of life.
• Traditional management of pediatric spasticity often involves a multidisciplinary approach with varying efficacy.
• Selective dorsal rhizotomy (SDR) has emerged as a key surgical intervention for specific types of spasticity.

Purpose of the Study:

• To review recent advancements in the surgical technique of selective dorsal rhizotomy.
• To evaluate the current understanding of patient selection and outcomes following SDR.
• To highlight the evolving role of SDR in the comprehensive management of pediatric spasticity.

Main Methods:

• Comprehensive literature search of peer-reviewed articles on selective dorsal rhizotomy in pediatric populations.
• Analysis of surgical technique modifications and refinements.
• Review of studies reporting functional outcomes, complications, and long-term results.

Main Results:

• Significant improvements in gait, motor control, and functional mobility are consistently reported post-SDR.
• Refinements in intraoperative neuromonitoring and surgical precision have enhanced safety and efficacy.
• Long-term follow-up data continue to support SDR as a durable treatment option for appropriate candidates.

Conclusions:

• Selective dorsal rhizotomy remains a highly effective surgical option for managing spasticity in select pediatric patients.
• Ongoing technical advancements and improved patient selection criteria are optimizing outcomes.
• SDR plays a crucial role in improving long-term functional independence and quality of life for children with cerebral palsy and other spasticity-related conditions.