van Dijk, Liza MM;
Slot, K Mariam;
Novacheck, Tom F;
Buizer, Annemieke I;
Langerak, Nelleke G;
Aquilina, Kristian;
Bo, Xiao;
... SDR, working group; + view all
(2025)
Selective dorsal rhizotomy from indication to rehabilitation: a worldwide survey.
Child's Nervous System
, 41
(1)
, Article 133. 10.1007/s00381-025-06786-5.
(In press).
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Abstract
Purpose: Selective dorsal rhizotomy (SDR) is a neurosurgical treatment used worldwide to reduce spasticity. The procedure has undergone many changes since its introduction in the early 1900s, and currently, different centers vary in many aspects of the procedure. We surveyed centers on different continents regarding SDR indications, surgical techniques, and postoperative rehabilitation. Methods: Ten centers worldwide with SDR experience participated in an online survey preparing for a pre-conference workshop in 2022. The main topics were patient characteristics, the selection process, surgery, and rehabilitation. Results: Universal suitable candidates for SDR were patients with bilateral spastic cerebral palsy, Gross Motor Function Classification System levels II or III, ages 5 to 7 years, and adequate strength, motor control, and access to postoperative rehabilitation. Centers differed in additional inclusion and exclusion criteria and the use of diagnostic tools. Both single- and multilevel approaches were used, with electrophysiological monitoring applied in all approaches. Intensive rehabilitation was recommended after surgery, followed by a less intensive program, with variations in duration, therapy frequency, modalities used, and follow-up periods. Conclusion: This survey demonstrated many similarities in several aspects of the SDR procedure in centers performing SDR worldwide, while considerable variability was also seen. The results emphasize the need for standardized reporting of SDR procedures and outcome measures to enable international comparative studies. A Delphi procedure could be a first step to reaching a consensus on outcome measurements, which may lead to a consensus regarding the most suitable candidates, surgical techniques, and rehabilitation programs to improve functional outcomes.
| Type: | Article |
|---|---|
| Title: | Selective dorsal rhizotomy from indication to rehabilitation: a worldwide survey |
| Location: | Germany |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1007/s00381-025-06786-5 |
| Publisher version: | https://doi.org/10.1007/s00381-025-06786-5 |
| Language: | English |
| Additional information: | Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. |
| Keywords: | Science & Technology, Life Sciences & Biomedicine, Clinical Neurology, Pediatrics, Surgery, Neurosciences & Neurology, Cerebral palsy, Rhizotomy, Selection, Neurosurgery, Rehabilitation, SPASTIC CEREBRAL-PALSY, CHILDREN, EFFICACY |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Developmental Neurosciences Dept |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10214155 |
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