Key points about selective dorsal rhizotomy
- selective dorsal rhizotomy (SDR) is an operation that cuts some sensory nerves in the spinal cord
- it reduces spasticity (stiffness) in the legs of tamariki with cerebral palsy
- SDR is not currently available in Aotearoa New Zealand
- if you are thinking about SDR, talk to your child’s healthcare team
- talk with them about whether SDR is the best option for your child
What is selective dorsal rhizotomy?
Selective dorsal rhizotomy (SDR) is a permanent neurosurgical operation. It reduces spasticity (stiffness) in the legs of tamariki with cerebral palsy.
What selective dorsal rhizotomy involves
SDR involves cutting selected sensory nerves in the spinal cord. This helps reduce spasticity in the legs.
SDR cannot be reversed or repeated. The cut nerves do not grow back.
A hospital stay
The operation takes several hours. Tamariki need to stay in hospital.
Intensive exercise programme
After the operation, tamariki need an intensive exercise programme. This helps them to get strong and moving again. Therapy usually continues for years.
Who might benefit from a selective dorsal rhizotomy
A full assessment with you, your child and a team of health professionals is important to work out if your child may benefit from SDR.
Benefits of selective dorsal rhizotomy
Benefits depend on your child’s function before surgery. Possible benefits include:
- reduced spasticity (stiffness)
- improved movement and function
- better balance, including sitting balance
- improved endurance
- better sleep
- less pain and fewer muscle spasms
- it may be easier to use equipment such as standing frames, special seating and orthotics
Possible risks from selective dorsal rhizotomy
Possible complications
Complications are uncommon but can include:
- infection
- leak of cerebrospinal fluid
- fluid collection under the skin
- severe leg weakness
- loss of bladder control
Possible long-term complications
- changes in sensation in the legs
- spinal curvature (scoliosis)
- more difficulty walking or balancing
Is selective dorsal rhizotomy available in Aotearoa New Zealand?
SDR is not currently available in Aotearoa New Zealand.
Some whānau choose to travel overseas for the operation, often to the United States or England, and pay for it themselves.
After returning to Aotearoa New Zealand, it may be difficult to access the level of therapy recommended after surgery. Without regular therapy, outcomes may not be as good.
Therapy after selective dorsal rhizotomy
After SDR, tamariki need intensive therapy for up to 2 years.
This may include:
- strengthening exercises
- coordination, balance and movement exercises
Tamariki need to be able to follow instructions and take part in therapy.
Important considerations for selective dorsal rhizotomy
SDR is permanent and cannot be reversed.
If you are thinking about SDR for your child, talk to your child’s healthcare team. They can help you decide whether SDR is the best option for your child.
Tamariki who have had SDR still need ongoing monitoring for longer-term conditions related to cerebral palsy.
More information
Gillette Children's has information on selective dorsal rhizotomy (SDR) surgery. Learn how the surgery works, who may be suitable for it and what to expect during recovery.
The Sydney Children's Hospitals Network has information on selective dorsal rhizotomy (SDR) surgery for children with cerebral palsy. They explains the procedure, possible benefits and risks, and factors to consider when making treatment decisions.
Acknowledgements
This content has been developed and approved by the Paediatric Neurodevelopment Clinical Network, Paediatric Society of New Zealand | Te Kāhui Mātai Arotamariki o Aotearoa.
