Selective Dorsal Rhizotomy (SDR) FAQs

It’s an operation, where the nerve roots in the lower spinal cord are selectively disconnected to reduce high muscle tone (spasticity) in the leg muscles in children with cerebral palsy. This procedure can only be done once, and only for children who are carefully assessed and selected to be suitable for surgery. When it’s supported by physiotherapy, it can greatly improve your child’s movement.

The surgery aims to:

•         achieve a long-term reduction in spasticity
•         improve function and mobility
•         increase independence
•         increase range of motion and improve positioning

Most of the evidence for SDR relates to children aged 4 to 10 years. Some centres perform the surgery on children outside this age range.

UK centres offering SDR

•         Alder Hey Children’s NHS Foundation Trust
•         Bristol Royal Hospital for Children
•         Great Ormond Street Hospital for Children
•         Leeds General Infirmary
•         Nottingham University Hospitals
•         The Portland Hospital for Women and Children
•         The Robert Jones and Agnes Hunt Orthopaedic and District Hospital NHS Trust

Some families also choose to attend St Louis Children’s Hospital, USA for SDR surgery.

As the surgery releases the muscles, the underlying weakness in those muscles can be exposed, particularly in the legs, which are essential for standing and walking. Initially, some activities might be more difficult as children have relied on the tension in their legs for stability. But this will improve as the muscles become stronger with intensive physiotherapy.

Because each child is different it will be bespoke to each child but usually it will be three to five times per week for the first three to six months followed by one or two sessions per week for 12-18 months. Some children have intensive blocks of therapy, where sessions happen twice a day for one or two weeks, which research has shown to support the best outcomes.