Selective Dorsal Rhizotomy
View a video presentation on the diagnosis and treatment of spastic cerebral palsy with Children’s Memorial Hermann Hospital pediatric neurosurgeon Dr. Manish N. Shah.
Selective dorsal rhizotomy (SDR) is the most effective treatment option for children and adults with cerebral palsy (CP) who suffer from spastic diplegia or spastic hemiplegia. Of all the treatments for spastic CP, SDR leads to the greatest, most lasting improvement in motor function.
At Children’s Memorial Hermann Hospital, pediatric neurosurgeons perform SDR using the most sophisticated surgical, diagnostic and imaging equipment. The postoperative mobility results can be excellent—young patients with a strong commitment to succeed can achieve independent walking.
Our multidisciplinary team is skilled in caring for the complex needs of a child with cerebral palsy. Their approach combines the expertise of affiliated pediatric neurosurgeons, pediatric neurologists, physical medicine and rehabilitation physicians, neuroradiologists, as well as physical therapists and occupational therapists, to ensure every child receives the best care available.
What is SDR?
In SDR, the patient undergoes a level one laminectomy, a surgical procedure in which the lamina (back part of the vertebra that covers the spinal canal) are removed in order to expose the nerve that control the lower extremities. These nerves are then tested in the operating room to measure their relative levels of spasticity. The most spastic nerves are cut in order to decrease the excessive muscle tone or tightness in the legs that is caused by spasticity.
About SDR Treatment
SDR surgery takes approximately two and half hours and usually requires a five-day stay in the hospital. The patient then undergoes a minimum of six to twelve months of intensive rehabilitation and physical therapy plus regular therapy during years that follow with the end goal of independent ambulation.
With minimal complications observed in a very low percentage of patients, SDR is an excellent option for many spastic CP patients. The majority of patients who undergo SDR and complete the requisite physical therapy are eventually able to walk completely on their own.
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About the Host
Manish Shah, M.D.
- Fellowship-trained pediatric neurosurgeon specializing in surgical management of spasticity in children and pediatric epilepsy surgery
- Extensive research focusing on functional imaging of the brain and advanced MRI techniques
- Director of Pediatric Spasticity and Movement Disorder Surgery at Children’s Memorial Hermann Hospital
- Assistant professor, departments of Pediatric Surgery and Neurosurgery, McGovern Medical School at UTHealth
- Affiliated with the renowned Memorial Hermann Mischer Neuroscience Institute at the Texas Medical Center
- Member of the American Association of Neurological Surgeons, AANS/CNS Joint Cerebrovascular Section and AANS/CNS Joint Pediatrics Section