A Selective Dorsal Rhizotomy is a term used to describe a neurosurgical procedure, which selectively destroys the nerve root in the spinal cord, to relieve the symptoms of spasticity in Cerebral Palsy.
This surgery was pinioned since 1980 http://guidance.nice.org.uk/IPG373
In this surgery the dorsal (sensory) nerve root is first separated from the ventral (motor) nerve root. Using EMG and scaling of the dorsal nerves, the nerves causing severe spasticity are then cut. The over firing non-Gaba absorbing dorsal nerves generate unusual EMG activity in the calf muscles. The result is permanent resolution of spasticity in the calf and without affecting nervous system sensitivity or function in other areas.
At the Birkdale clinic, we have a long history of treating children with Cerebral Palsy from a young age to adulthood and we also treat adults with Cerebral Palsy. As a result we have a lot of experience of working with children who have had a Selective Dorsal Rhizotomy.
In our experience, children with cerebral palsy have; a complex postural alignment, muscle tone and pattern of movements. These symptoms in combination with their visual complexity also result in impaired balance in varying postural sets; lying, sitting and standing.
At the Birkdale Clinic we treat ensure a holistic approach to ensure all symptoms are addressed, which includes; sensory feedback to improve postural alignment, facilitation of normal movement patterns through play, work on ocular cephalic and vestibular activity and ensure their balance is challenged in each postural set using varying items of equipment.
Finally we have found the use of functional electrical stimulation to be very successful, through enhancing the child’s movements and improving muscle recruitment.