The progress in the treatment of spastic cerebral palsy with selective dorsal rhizotomy (SDR)

Abstract

Spasticity is the main disabling clinical manifestation of children with cerebral palsy (CP). Selective dorsal rhizotomy (SDR) has been performed for the treatment of spastic CP in Asia for quite some time from 1990. The purpose of this review is to discuss the historical origin and development of SDR. Our goal here is to identify the current patient selection criteria for SDR and to point out indications and contraindications based on the patients with CP, age from 2 to 18 years-old, over 6000 cases, who received SDR surgery with spasticity of muscle tension more than 3 degrees in our center. We also discuss evidence-based approaches on how to evaluate postoperative patient outcomes of SDR and how complications can be avoided. Finally, we mention progress made in terms of SDR technical advances and how improvements can be made in the future. In conclusion, SDR surgery is a reliable way to improve outcomes of patients with spastic CP and can be done carefully in patients as long as stringent selection criteria are used. However, more research and technological advancements are needed to help address associated complications.

Tendon transfer in spastic cerebral palsy upper limb

“…Forty-two patients, 16 male and 26 female, with a mean age of 19.81 (10-34 years, SD: 5.36) years with a mean follow-up of 5.5 (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14) years, entered the study. 10 cases were 10-16 years, 29 cases were 17-25, and 3 were 26-34 years old at time of surgery.…”

“…Different tools for assessing the function have been designed [9]. While the gross motor function of a CP patient is measured by GMFCS, the Manual Ability Classification System (MACS) is a tool for upper limb function assessment [2,10]. The QuickDASH score (Disability of Arm, Shoulder, and Han) also provides an upper extremity evaluation score.…”