Physiotherapy is an important part of Selective Dorsal Rhizotomy (SDR)

What is Selective Dorsal Rhizotomy (SDR)?

Selective Dorsal Rhizotomy (SDR) is a neurosurgical procedure designed to reduce spasticity, a common feature of cerebral palsy that causes tight, stiff muscles. Spasticity can interfere with movement, posture, and overall motor function, making everyday activities challenging for children with cerebral palsy.

How SDR Works

SDR involves targeting the nerve roots in the spinal cord that contribute to spasticity. During the procedure:

1. Nerve Identification: The surgeon makes a small incision in the lower back to access the spinal cord. Using advanced techniques, they identify the sensory nerve fibres responsible for sending excessive signals to the muscles.
2. Selective Cutting: Specific nerve rootlets causing spasticity are carefully divided, while healthy ones are preserved. This reduces the overactivity in the muscles, allowing for smoother and more controlled movements.

Who Can Benefit from SDR?

SDR is typically recommended for children with cerebral palsy who:

• Experience significant spasticity that interferes with mobility or quality of life.
• Have the ability to strengthen their muscles and improve function through physiotherapy after the surgery.
• Do not have significant weakness or other complicating conditions that would limit their ability to benefit from the procedure.

This surgery is most commonly performed on children with spastic diplegia, a form of cerebral palsy that primarily affects the legs. However, suitability is determined on an individual basis after thorough assessment by a multidisciplinary team.

Expected Outcomes of SDR

By reducing spasticity, SDR can:

• Improve walking patterns and mobility.
• Enhance comfort by reducing pain and stiffness.
• Enable greater ease of movement in everyday activities.

While SDR can produce dramatic improvements, it is not a standalone cure for cerebral palsy. It works best when paired with intensive post-surgery rehabilitation, particularly physiotherapy, to help children adapt to the changes in their body and develop new, more functional movement patterns.

This holistic approach of surgery combined with ongoing therapy ensures that children can make the most of the opportunities SDR provides to improve their independence and quality of life.

Benefits of Physiotherapy Before and After SDR

The success of SDR largely depends on comprehensive physiotherapy both before and after surgery. Here’s why physiotherapy is essential during this journey:

Pre-Surgery Physiotherapy

1. Building Strength and Flexibility: Preparing muscles for the changes after surgery helps optimise outcomes. Strengthening key muscle groups and improving joint flexibility sets a strong foundation for recovery.
2. Posture and Movement Preparation: Physiotherapy focuses on improving posture and movement patterns, helping children practise functional activities that will be crucial after surgery.
3. Family and Child Education: Physiotherapists help families understand what to expect, ensuring children and caregivers feel confident about the rehabilitation process.

Post-Surgery Physiotherapy

1. Strengthening Weak Muscles: Following SDR, reduced spasticity often reveals underlying muscle weakness. Physiotherapy targets these areas to rebuild strength and stability.
2. Improved Mobility and Balance: Physiotherapy helps children relearn and refine movements, promoting better coordination, balance, and overall mobility.
3. Maximising Independence: Regular therapy supports the development of functional skills like walking, sitting, and transitioning, empowering children to achieve greater independence in daily activities.
4. Preventing Complications: Ongoing physiotherapy reduces the risk of secondary issues such as joint stiffness, muscle contractures, and poor posture.

A Personalised Approach

Every child’s needs and goals are unique. At Michelle Cox Neuro Physio we will design an individualised programme tailored to the child’s specific abilities and aspirations, ensuring optimal results from SDR surgery.

Physiotherapy is not just a supplement to SDR—it’s an essential component that enables children with cerebral palsy to reach their fullest potential. By working closely with skilled professionals, families can help their children make meaningful progress and enjoy improved quality of life.

If you are living in Romsey, Chandlers Ford, Winchester, New Forest or surrounding areas (Hampshire) or Salisbury (Wiltshire) get in contact today to see how we can support your child.