Selective dorsal rhizotomy

Selective dorsal rhizotomy (SDR) is the most common nerve surgery for symptoms related to cerebral palsy (CP). During SDR, a surgeon cuts the skin over the lower part of the spinal cord. The surgeon then finds and cuts the nerves in the cord that are causing muscle tightness in the legs.

Selective dorsal rhizotomy may be done to relieve muscle tightness and spasticity when CP severely affects the legs. The procedure may also improve the range of movement in the legs.

SDR is especially useful when cerebral palsy affects both legs but not the arms (spastic diplegia). It is usually not advised for people who have permanently stiff joints (contractures), little strength in their limbs, or problems with balance.

Some children have less muscle tightness (spasticity) and are able to move their legs more easily after SDR, although their legs may feel weaker and somewhat numb. Sometimes spasticity completely goes away.

This surgery may decrease the chances of leg deformities in growing children. When muscles tighten around growing bones, the bones may not develop normally.

SDR cuts the nerves that cause spasticity and helps prevent the muscle from tightening again. When SDR is done before orthopedic surgery, it may increase the success of that surgery.