scholarly journals Long‐term effects of selective dorsal rhizotomy in children with cerebral palsy: a systematic review

2019 ◽  
Vol 62 (5) ◽  
pp. 554-562 ◽  
Author(s):  
Kristina Tedroff ◽  
Gunnar Hägglund ◽  
Freeman Miller
Author(s):  
Bruce A MacWilliams ◽  
Mark L McMulkin ◽  
Elizabeth A Duffy ◽  
Meghan E Munger ◽  
Brian Po‐Jung Chen ◽  
...  

2018 ◽  
Vol 12 (5) ◽  
pp. 413-427 ◽  
Author(s):  
K. K. Wang ◽  
M. E. Munger ◽  
B. P.-J. Chen ◽  
T. F. Novacheck

Background Selective dorsal rhizotomy (SDR) is a surgical procedure for treating spasticity in ambulant children with cerebral palsy (CP). However, controversies remain regarding indications, techniques and outcomes. Current evidence summary Because SDR is an irreversible procedure, careful patient selection, a multi-disciplinary approach in assessment and management and division of the appropriate proportion of dorsal rootlets are felt to be paramount for maximizing safety. Reliable evidence exists that SDR consistently reduces spasticity, in a predictable manner and to a substantial degree. However, functional improvements are small in the short-term with long-term benefits difficult to assess. Future outlook There is a need for high-quality studies utilizing long-term functional outcomes and well-matched control groups. Collaborative, multicentre efforts are required to further define the role of SDR as part of the management paradigm in maximizing physical function in spastic CP.


2006 ◽  
Vol 105 (1) ◽  
pp. 8-15 ◽  
Author(s):  
Jack R. Engsberg ◽  
Sandy A. Ross ◽  
David R. Collins ◽  
Tae Sung Park

2013 ◽  
Vol 35 (5) ◽  
pp. E6 ◽  
Author(s):  
William C. Gump ◽  
Ian S. Mutchnick ◽  
Thomas M. Moriarty

Children with spastic diplegia from cerebral palsy (CP) experience measurable improvement in their spasticity and motor function following selective dorsal rhizotomy (SDR). The role of this operation in the treatment of other spasticity causes is less well defined. A literature review was undertaken to survey outcomes from SDRs performed outside the CP population. Multiple sclerosis was the most common diagnosis found, accounting for 74 of 145 patients described. Selective dorsal rhizotomies have also been reported in patients with traumatic brain and spinal cord injuries, ischemic and hemorrhagic stroke, neurodegenerative disease, hypoxic encephalopathy, and other causes of spasticity. Outcomes from surgery are generally described as favorable, although postoperative assessments and follow-up times are not standardized across reports. Long-term outcomes are sparsely reported. Larger numbers of patients and more detailed outcomes data have the potential to form a basis for expanding the inclusion criteria for SDR.


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