Selective Dorsal Rhizotomy for Spasticity in Cerebral Palsy

Selective dorsal rhizotomy (SDR) to permanently reduce lower‑extremity spasticity and improve motor function in children with spastic cerebral palsy, primarily those with spastic diplegia or quadriplegia who are GMFCS level II–III, aged >2 and <10 years, with good trunk control, antigravity lower‑extremity strength, and ability to participate in postoperative rehabilitation. SDR is limited to rigorously selected candidates who have failed or cannot tolerate conservative treatments, have no significant ataxia/dystonia or scoliosis, have MRI findings without thalamic/basal ganglia/cerebellar involvement, have had no botulinum toxin A in the prior 6 months or orthopedic surgery in the prior year, and is not indicated for hemiplegia or GMFCS IV–V patients.

"Selective dorsal rhizotomy (SDR) to reduce spasticity and improve mobility in children with cerebral palsy and lower extremity spasticity"