Selective dorsal rhizotomy (the perspective of the neurosurgeon and physiotherapist)

Cawker, Stephanie; Aquilina, Kristian

doi:10.1016/j.paed.2016.04.018

Cited by 7 publications

(7 citation statements)

References 6 publications

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“…This allows the goals of rehabilitation to be modified according to the patient's gains. As patients regain skills over the course of rehabilitation, therapy transitions Early recovery from single-level laminotomy SDR is usually fast, with patients commencing PT by day 3 or 4 post-SDR (22). Ongoing PT is required for up to 2 years post-SDR, but intensive daily PT is required in the initial 2-3 weeks (22).…”

Section: Rehabilitation From Sdrmentioning

confidence: 99%

“…As patients regain skills over the course of rehabilitation, therapy transitions Early recovery from single-level laminotomy SDR is usually fast, with patients commencing PT by day 3 or 4 post-SDR (22). Ongoing PT is required for up to 2 years post-SDR, but intensive daily PT is required in the initial 2-3 weeks (22). During this period, reduced sensory feedback limits the ability of patients to maintain movement control rather than post-surgical weakness.…”

Section: Rehabilitation From Sdrmentioning

confidence: 99%

“…The most rapid gains usually occur within the first 3 to 6 months post-SDR, and therapeutic aims are to develop motor learning combined with musculoskeletal change (22). Over this period, the goals of PT include movement control, resistance strengthening, fitness and endurance.…”

Section: Rehabilitation From Sdrmentioning

confidence: 99%

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Single-level selective dorsal rhizotomy for spastic cerebral palsy

Graham¹,

Aquilina²,

Cawker³

et al. 2016

J. Spine Surg.

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The management of cerebral palsy (CP) is complex and requires a multidisciplinary approach. Selective dorsal rhizotomy (SDR) is a neurosurgical technique that aims to reduce spasticity in the lower limbs.A minimally invasive approach to SDR involves a single level laminectomy at the conus and utilises intraoperative electromyography (EMG). When combined with physiotherapy, SDR is effective in selected children and has minimal complications. This review discusses the epidemiology of CP and the management using SDR within an integrated multidisciplinary centre. Particular attention is given to the single-level laminectomy technique of SDR and its rationale, and the patient workup, recovery and outcomes of SDR.

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Section: Rehabilitation From Sdrmentioning

confidence: 99%

Section: Rehabilitation From Sdrmentioning

confidence: 99%

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Single-level selective dorsal rhizotomy for spastic cerebral palsy

Graham¹,

Aquilina²,

Cawker³

et al. 2016

J. Spine Surg.

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“…• Start as soon as possible (after 94 hours, the risk of a dura leak is significantly reduced). 94,106 • Start with gentle passive range of motion and build up toward an intensive active program until at least 12 months postoperatively. In our center, 3 to 4 months of intensive rehabilitation at the hospital, is followed by an intensive home program of minimally 1 year.…”

Section: Specific Key Points In Pt After Sdrmentioning

confidence: 99%

“…In our center, 3 to 4 months of intensive rehabilitation at the hospital, is followed by an intensive home program of minimally 1 year. 106,107 • Restrict passive hamstrings stretch and trunk rotation for the first 3 to 6 weeks.…”

Section: Specific Key Points In Pt After Sdrmentioning

confidence: 99%

Tone Reduction and Physical Therapy: Strengthening Partners in Treatment of Children with Spastic Cerebral Palsy

et al. 2019

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The aim of this paper is to provide a clinically applicable overview of different tone reducing modalities and how these can interact with or augment concurrent physical therapy (PT). Botulinum toxin (BoNT), oral tone-regulating medication, intrathecal baclofen (ITB), and selective dorsal rhizotomy are discussed within a physiotherapeutic context and in view of current scientific evidence. We propose clinical reasoning strategies to identify treatment goals as well as the appropriate and corresponding treatment interventions. Instrumented measurement of spasticity, standardized clinical assessment, and 3D clinical motion analysis are scientifically sound tools to help select the appropriate treatment and, when needed, to selectively target or spare individual muscles. In addition, particular attention is given to strength training as a necessary tool to tackle muscle weakness associated with specific modalities of tone reduction. More research is needed to methodologically assess the long-term effectiveness of such individualized tone treatment, optimize parameters such as medication dosage, and gain more insight into the kind of PT techniques that are essential in conjunction with tone reduction.

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