“…16 Clinical studies have demonstrated that SDR results in short-and long-term improvement in lower-extremity tone and can lead to improved mobility, improved lower-limb function, decreased need for orthopedic surgical interventions, and an increased level of self-care for children with spastic diplegia and spastic quadriplegia. 2,5,7,8,10,12,15,18,19 Although nerve rootlet transection is limited to the lumbosacral rootlets in SDR, early anecdotal reports in the 1980s suggested the unexpected observation of improvements above the level of the lower extremities, termed "suprasegmental effects." Over the next decade, a number of small case series emerged describing improvement in upper-extremity function or tone following SDR, but only described qualitative improvement or quantitative improvement in select upper-extremity muscle groups.…”