What is Selective Dorsal Rhizotomy (SDR)

Of all the surgical procedures currently performed on patients with Cerebral Palsy (CP), selective dorsal rhizotomy (SDR) has undergone more thorough scientific scrutiny than any other (including orthopedic surgery). Accumulated evidence and our own experience indicate that SDR is an excellent option for selected patients with Spastic Cerebral Palsy.

The Selective Dorsal Rhizotomy Procedure

SDR involves sectioning (cutting) of some of the sensory nerve fibers that come from the muscles and enter the spinal cord. Two groups of nerve roots leave the spinal cord and lie in the spinal canal. The ventral spinal roots send information to the muscle; the dorsal spinal roots transmit sensation from the muscle to the spinal cord.

At the time of the operation, the neurosurgeon divides each of the dorsal roots into 3-5 rootlets and stimulates each rootlet electrically. By examining Electromyographic (EMG) responses from muscles in the lower extremities, the surgical team identifies the rootlets that cause spasticity. The abnormal rootlets are selectively cut, leaving the normal rootlets intact.This reduces messages from the muscle, resulting in a better balance of activities of nerve cells in the spinal cord, and thus reduces spasticity.