Surgery for Spasticity

Should nerve surgery be considered in non-ambulant children?

Aside from medication and physiotherapy, parents of children with cerebral palsy may be interested in surgical management of their child’s spasticity (abnormal muscle tightness). Selective Dorsal Rhizotomy (SDR) is a common nerve surgery which could improve gross motor function and the quality of life in children with CP. During SDR, the surgeon will cut the nerves in the spinal cord that are causing muscle tightness in the legs. Currently, there is limited evidence on the effectiveness of SDR in non-ambulant children who cannot walk or sit without support. Ambulant children with higher motor function and independence are the traditional candidates for SDR.

Should SDR be considered a treatment option in non-ambulant children? This study assessed the effects of SDR on motor function and quality of life in non-ambulant children with spastic diplegic CP, aged 3 to 18. The results are promising for parents interested in surgical procedures or in general, more treatment options to manage spasticity.

SDR generally improved gross motor function and reduced pain in most non-ambulant children at 24 months after surgery, although the benefit is less pronounced than in ambulant children. Nonetheless, the study suggests that SDR be considered in non-ambulant children as they may also receive some benefit.

The paper also warns parents that like other surgeries, SDR carries a risk of complications such as bleeding and infection. Regular post-operative physiotherapy and other treatments will be needed. It is also important for parents to manage realistic expectations, as some children may gain little to no benefit from SDR. More research is needed in this area to clarify the eligibility for SDR.

Parent resources

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CP Smile Project

The CP Smile Project is a community project that helps ensure children with cerebral palsy have access to recreational opportunities that allow them to engage in play and community involvement. We give monthly bursaries to families to help them provide the support needed for their child to engage in play and have fun.