SELECTIVE
DORSAL
RHIZOTOMY
Surgical treatment of children with spastic cerebral palsy
Selective dorsal rhizotomy (SDR) is a surgical procedure that selectively cuts some of the roots of the dorsal nerve in the spine in children with spastic cerebral palsy, in order to reduce spasticity mainly in the lower extremities, so as to improve their motor function after a rehabilitation program after SDR.
Prof. XIAO BO
Dear Parents,
I am Prof. Xiao Bo, a highly accomplished pediatric neurosurgeon who specializes in surgical treatments for all types of pediatric neurosurgical disorders, particularly those with spastic cerebral palsy. I hold board certifications in both China and Israel and am the Chief of Pediatric Neurosurgery Department and Director of the Cerebral Palsy and Spasticity Center at Shanghai Children's Medical Center in Shanghai, China, as well as the Chief of the Selective Dorsal Rhizotomy (SDR) Center at Dana-Dwek Children’s Hospital, Sourasky Medical Center in Tel Aviv, Israel.
With over a decade of experience in this field, I have dedicated myself to improving the surgical treatment outcomes for children with spastic cerebral palsy. My team and I have accumulated over 1 million pairs of input-output intraoperative neurophysiological data from lower spinal cords in patients with spastic cerebral palsy, leading to the establishment of the world's first human spinal nerve evoked-CMAP database. This database has provided new opportunities for optimizing SDR protocols and improving surgical treatment outcomes, as well as for further understanding the principles and modes of spinal cord networks in populations with spastic cerebral palsy.
In 2018, I developed a standardized intraoperative EMG interpretation scheme to guide SDR in a quantitative manner, which has been used in over 600 SDR procedures and has shown excellent outcomes. .......
Patients For SDR
Conditions for the SDR operation:
All types of patients with spastic cerebral palsy aged 4 to 14 years are good candidates for our SDR, including diplegy, quadriplegy, triplegy and hemiplegy, regardless of their preoperative level of GMFCS. (spasticity class).
The best age for our SDRs is from 4 to 14 years, the age we did is 16 years, the results are still good, but require a longer rehabilitation program.
Since mid-2016, our team has completed more than 450 SDRs with excellent results and without complications.
SDR is the only surgical procedure that can ensure a constant reduction in spasticity in cerebral palsy in children. Improves the balance in the standing and walking position.
Selective dorsal rhizotomy reduces the severity of contractures of the hamstring tendon and heel rope. As a rule, there are improvements in tiptoe gait after SDR. Improves posture in a sitting and standing position.
SDR has a positive effect on the joints and muscles of the limbs, restoring normal movements, reduces deformity of limbs.
After SDR surgery and 3-day bed rest in the hospital, the child needs an individual set of rehabilitation measures to restore. Most of this program is studied during the preoperative physiotherapy program and during hospital stay. Then parents are provided with specific types of activities and methods.
