Next steps

Summary

What do we know about SDR as a treatment option for your child?

  • SDR lessens leg spasticity permanently
  • SDR is not likely to change your child鈥檚 GMFCS level or wearing of AFOs e.g. if your child needs a walker and AFOs to walk, he/she will still likely need them long term after SDR
  • Your child may need surgery to correct bone and muscle problems in the future
  • SDR is a major operation with long term results. We suggest trying other treatments first to see if there is a treatment other than SDR that achieves the same goals eg. Botulinum toxin-A injections
  • Your child will need to take part in an intensive rehab program for 1 to 2 years for best results
  • Weakness may be an ongoing problem
  • You need to maintain a close relationship with your local Rehab team for support and advice on the right treatment option/s for your child.

Where do I go to find out more about SDR?

For SDR operations:

  • Speak to your local Rehab team for advice
  • Your local rehab team will discuss treatment options for your child and refer you to the rehab team that does the operation in your state for an opinion.

Next steps

Having read through this decision aid about SDR, you may want to:

  1. Continue with your child鈥檚 current treatment plan.
  2. Make an appointment with your rehab team to talk about SDR as a treatment option for your child.

Now that you have thought about the facts and what matters most to you, which way are you leaning now?

Yes no or unsure graphic

We encourage you to use this information, speak with your community therapy team and hospital health care team, and talk about best treatment options for your child.

References:

Aquilina K, Graham D, Wimalasundera N. Selective dorsal rhizotomy: an old treatment re-emerging. Arch Dis Child. 2015;100(8):798-802.

Dudley RW, Parolin M, Gagnon B, et al. Long-term functional benefits of selective dorsal rhizotomy for spastic cerebral palsy. Journal of Neurosurgery: Pediatrics. 2013;12(2):142-50.

Lewis JA, Bear N, Smith N, Baker F, Lee OS, Wynter M, Paget SP, Selective Dorsal Rhizotomy-Australian Registry Management Committee. Goal setting, goal attainment and quality of life of children following selective dorsal rhizotomy. Child: care, health and development.

Lewis J, Bear N, Baker F, Fowler A, Lee O, McLennan K, Richardson E, Scheinberg A, Smith N, Thomason P, Tidemann A. Australian children undergoing selective dorsal rhizotomy: protocol for a national registry of multidimensional outcomes. BMJ open. 2019 Apr 1;9(4):e025093.

Munger ME, Aldahondo N, Krach LE, et al. Long-term outcomes after selective dorsal rhizotomy: a retrospective matched cohort study. Dev Med Child Neurol. 2017;59(11):1196-203.

Nordmark E, Josenby AL, Lagergren J, et al. Long-term outcomes five years after selective dorsal rhizotomy. BMC Pediatr. 2008;8:54.

Tu A, Steinbok P. Long term outcome of selective dorsal rhizotomy for the management of childhood spasticity- functionalimprovement and complications. Childs Nerv Syst. 2020;36:1985-1994

Warsi , Tailor J, Coulter IC et al.et al. Selective dorsal rhizotomy: an illustrated review of operative techniques. J Neurosurg Pediatr 2020.