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Selective dorsal rhizotomy (SDR) is a highly refined, specialised surgery that aims to decrease muscle stiffness within cerebral palsy. When surgery is performed, it cuts segregated rootlets at specific points in the spinal cords of patients who experience hypertonia by nerve damage at the periphery of these rootlets, thereby enhancing mobility and decreasing pain.

The primary objective of Selective Dorsal Rhizotomy (SDR) is to reduce spasticity, or muscle tightness and stiffness, in children and adults with cerebral palsy, typically spastic diplegia. The procedure enhances motor function, reduces pain, enhances mobility, and enhances the effectiveness of physical therapy by severing abnormal nerve rootlets in the spinal cord.

Consult a paediatrician or neurologist if your child is experiencing painful muscle stiffness or causes deformity, persistent spasticity that interferes with walking, standing, or sitting, or does not alleviate with physical therapy. The average age for candidates is 2–12 years, with children with spasticity potentially being helped as well.

A team comprising specialists in physical therapy, neurology, and orthopaedic surgery conducts the intensive review during preparation. EMG, gait analysis, functional motor evaluations, and MRIS of the brain and spine are some examples of procedures performed. Psychiatric and nutritional assessments, alterations to medications, and initiating physical therapy are just some of the requirements patients may need before undergoing surgery.

General anaesthesia is administered during the procedure. The doctor:
Incision: An incision is made in the lower back of the lumbar spine.
Exposes the spinal cord and identifies the rootlets of sensory nerves.
Determines the rootlets producing the abnormal impulses through electrical stimulation.
Decrease spasticity by selectively cutting the offending rootlets.

The operation typically lasts 4 to 6 hours, and the hospital stay is generally 3 to 7 days. Rehabilitation after an operation lasts for a few months to years and includes intensive physical therapy.

Weakness
Numbness or sensory loss
Bowel or bladder dysfunction
Spinal deformity over time

SDR can enhance mobility and gait, reduce pain, increase independence in daily activities, and significantly decrease muscle stiffness. As a consequence, future orthopaedic surgery and long-term spasticity medication might be avoided.

Pain management and bed rest are required during the early stages of rehabilitation. To maximise motor gains, intensive physical therapy starts shortly after surgery and continues for months. Orthopaedic evaluation, therapy modification, and muscular strength monitoring are all components of long-term follow-up.

The majority of patients undergoing rhizotomy experience significant improvement in spasticity or chronic pain relief. A few individuals, however, experience little or no pain relief. Further information about the likelihood of success for your specific procedure can be found through your treatment team.