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Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Quant+Imaging+Med+Surg 2018 ; 8 (2): 209-18 Nephropedia Template TP
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Selective dorsal rhizotomy: current state of practice and the role of imaging #MMPMID29675362
Graham D; Aquilina K; Mankad K; Wimalasundera N
Quant Imaging Med Surg 2018[Mar]; 8 (2): 209-18 PMID29675362show ga
Spastic diplegic cerebral palsy (CP) is the most common form of CP. A specific goal-oriented approach, tailored to the child, is essential to management in all forms of CP. Selective dorsal rhizotomy (SDR) is a neurosurgical procedure that permanently reduces lower limb spasticity in children with spastic diplegic CP. The current technique is performed through a single level laminectomy at the level of the conus and, with the aid of intraoperative electromyography (EMG), allows selective division of the afferent lumbosacral nerve roots. In carefully selected children, reduction in spasticity has positive effects on the growing child. SDR is associated with minimal complications and good long-term outcomes. This article describes the surgical technique and patient selection, including the importance of medical imaging, and discusses the long-term outcomes of SDR.