A randomized clinical trial to compare selective posterior rhizotomy plus physiotherapy with physiotherapy alone in children with spastic diplegic cerebral palsy A randomized controlled single-blind trial was performed to compare lumbo-sacral selective posterior rhizotomy (SPR) followed by intensive physiotherapy, with intensive physiotherapy alone in improving motor function in children with spastic diplegic cerebral palsy. Fifteen patients were randomly assigned to each treatment modality. Patients in the SPR group had rhizotomy within 1 month, followed by intensive outpatient physiotherapy for 9 months. Patients assigned to physiotherapy alone had identical intensive physiotherapy. There was a statistically significant and clinically important difference in improvement in motor function in favor of the SPR group, with a mean increase in total Gross Motor Function Measure (GIMFM) score of 11.3% at 9 months for the SPR group compared with 5.2% for the physiotherapy-only group (P=O.OW) . Significant improvements in spasticity (Py-only group tlecitletl that they w e r~ not l)reparetl to wait for surgery later. iintl tlie ~~ar~iitsoftlieotliercliiltl assigned to the SPR group later irfiisetl rhizotoiny. C'hiltlren in theSPR group , ranged i n tige froiii 35 to 75 months (mean 50 montlis. median 47 months), antl in the coiitrol gi-oup from 35 to 77 months (iiiean 47 months. median 42 nionths).Sis children \vho were potentially eligible were not entered into the study, but \vent on to undergo a rhimtomy Three of these patients did not meet all tlie eligibility cr...

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SDR yields durable reduction in spasticity after 10 years. Early improvements in motor function are present, but at long-term follow-up, these improvements were attenuated in GMFCS II and III and were not sustained in GMFCS IV and V.