What is SDR?
Selective Dorsal Rhizotomy (SDR) is a surgical procedure that aims to reduce spasticity in the legs of children with cerebral palsy.
Spasticity in people with CP results from damage to the part of the brain that controls muscle tone and movement. While SDR is not a cure for cerebral palsy, it aims to enhance the quality of life and mobility in children affected by the condition. It can only be done once and is irreversible, therefore your doctor should assess whether the child is a suitable candidate.
SDR alone will only eliminate the spasticity that hinders a child’s ability to gain strength and function. To achieve gross motor goals, appropriate therapy focused on strength and correct movement patterns must be provided after SDR. Although the optimal therapy duration and intensity are debated, repetitive practice several times a week focused on strength and motor learning is essential. Some studies also indicate that pre-surgical therapy can enhance post-surgical outcomes and help families prepare physically and psychologically for the post-surgery period.
Who is SDR typically suitable for?
- SDR is for children whose main challenge is spasticity – aged 3-9 years old. They must also not have any dystonia or major spine/hip deformities.
- SDR is also performed on children with severe affection to improve their posture such as while sitting in a wheelchair.
What are the risks of SDR surgery?
SDR is a complex minimal invasive spinal surgery, and with that, all the usual risks of surgery come with it. These could be significant as it involves the spinal nerves; although research shows this is very rare in the UK. Please ask your doctor or medical provider for more detailed information about this.
What can we expect after SDR surgery?
After your child has completed surgery, their legs might appear weaker and less stiff. They might complain of back pain or numbness/hypersensitivity in their feet. This is normal and should be resolved with time.
The hospital team will give your child medication if appropriate and will also start your child on intensive physiotherapy. This process can be frustrating for children as they are suddenly unable to do things they have been doing previously. Muscles affected by spasticity are also weak hence with consistent strengthening, the aim is to regain their function and have the chance to improve this.
Where to find more information about SDR
- Alder Hey Children’s Hospital – NHS Foundation Trust: Selective Dorsal Rhizotomy (SDR), Information about the Selective Dorsal Rhizotomy (SDR) service at Alder Hey.
- APCP – Association of Paediatric Chartered Physiotherapists: Selective Dorsal Rhizotomy (SDR), Information for families and carers considering SDR surgery.
- Leeds Teaching Hospital – Selective Dorsal Rhizotomy: Information for parents/carers.
- Caudwell funding for SDR
- GOSH SDR, outcome measures
What is the SDR Therapy Pathway and how can it help?
The SDR Therapy pathway is a tailor-made rehabilitation plan designed to support children before and after Selective Dorsal Rhizotomy (SDR) surgery. It includes a combination of a pre surgical advice and therapy plan, post-surgery assessments, individualised post-surgery therapy, and ongoing monitoring in the way of routine outcome measures to enhance motor function and mobility. The goal is to maximize the child’s potential by focusing on strength, coordination, and functional skills, ensuring long-term improvements in a child’s movement and quality of life.
At CPotential, our clinicians specialise in creating personalised therapy plans tailored to the unique needs of each child and family following SDR surgery. With extensive experience in both pre and post-SDR therapy, we have achieved successful outcomes for many children. Our multidisciplinary team brings together a wealth of knowledge, expertise, and treatment approaches to help optimise a child’s abilities and recovery throughout their SDR journey.
How much is the SDR Pathway?
An SDR Pathway will be tailored to suit the needs of each child, and therefore may vary in cost depending on what is required. See baseline fees here.
There is a fee of £45 for an initial assessment to access all CPotential services.
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