Assessing a child for SDR

What do clinicians look for when assessing a child for Selective Dorsal Rhizotomy?

Your Rehab team will ask questions about:

  • Your child鈥檚 diagnosis 
  • Your pregnancy and birth history. Genetic testing may be suggested. 
  • Previous medical imaging of the brain and spine. MRI of the brain and spine may be suggested.

Your Rehab team will do:

  • A physical examination to measure muscle tightness, muscle stiffness (spasticity +/- dystonia), strength and movement control in the legs. 
  • A functional assessment to measure mobility and walking.

Based on scientific research literature, we know children who benefit most from SDR have:

  • Diagnosis of bilateral spastic CP 
  • History of premature birth (<37 weeks), and injury in a certain area of the brain (PVL) 
  • Young age at the time of surgery: 4 to 8 years of age 
  • Spasticity in muscles around the hips, knees and ankles of both legs 
  • Reasonable muscle strength and movement control in the legs 
  • No major muscle tightness/shortening (known as contracture) in the legs 
  • A very supportive family committed to an intensive rehab program 
  • Motivation, and be able to understand instructions, so that he/she can learn new ways of moving.

Keep in mind

Each child is individual and your child may not have all of these criteria. There may be better treatment options besides SDR for your child. 

SDR may not be beneficial for your child if:

  • There is injury in other parts of the brain that cause other movement problems. 
  • Spasticity is related to a progressive genetic condition. 
  • There are other types of muscle stiffness, such as dystonia, having a large impact on function. SDR lessens spasticity only - it will not help other muscle and movement problems. 
  • There is no access to intensive rehab after the surgery. There is risk of losing functional mobility due to underlying weakness when spasticity is taken away. Intensive physio after SDR helps strengthen muscles and lessen this risk.