Surgery in the USA called Selective Dorsal Rhizotomy and post-surgical therapies in Portugal
My name is Rafael, I have cerebral palsy, and I am 15 years old. I have already done some crowdfunding for intensive therapies and treatments for spasticity in Barcelona. The last one I did in Barcelona didn't help my spasticity and mobility as much as the previous ones, and my parents felt the need to look for other solutions because since I entered adolescence (age 10), I have grown very quickly, and my spasticity has worsened.
This caused many of the gains I had made to be lost, I can no longer move as well, I walk with great difficulty using a walker, more deformities appear, and I experience pain.
In the USA, more specifically at St. Louis Children's Hospital, they are a reference center for spasticity and this surgery; it was invented there in 1980 and they have extensive experience worldwide.
What this surgery involves:
Selective Dorsal Rhizotomy (SDR)
Of all the surgical procedures currently performed on people with cerebral palsy (CP) , selective dorsal rhizotomy (SDR) is one of the interventions that has been most thoroughly studied scientifically, including in comparison with orthopedic surgery.
The accumulated evidence, along with the expertise of specialists, indicates that SDR may be a suitable option for certain patients with spastic cerebral palsy .
The authors argue that parents and patients themselves should inform themselves and discuss the possibility of SDR as part of the treatment for cerebral palsy before proceeding with certain orthopedic surgeries .
In simple terms: SDR is a surgery designed to reduce spasticity by identifying and selectively cutting certain sensory nerve fibers that contribute to muscle stiffness. The goal is to provide a more lasting reduction in spasticity and subsequently leverage this improvement through physiotherapy and other intensive therapies .
It is important to emphasize that SDR is not suitable for all children with cerebral palsy . Selection depends on several factors, such as the type and distribution of spasticity, muscle strength, motor control, functional capacity, and the child's goals.
In my case, I was accepted and already had a consultation in Madrid on September 16th, as the American doctor came to Europe to make personal visits.
advantages that the medical team believes exist in their Selective Dorsal Rhizotomy (SDR) technique compared to other techniques.
Advantages of the SDR technique
-
Lower risk of spinal deformities in the future.
The technique is performed in an attempt to reduce the risk of spinal alterations or deformities that may occur later. -
Less muscle weakness after rhizotomy.
The aim is to reduce spasticity without causing excessive loss of muscle strength, thus better preserving the child's ability to move. -
Reduction of spasticity in the hip flexors
The technique involves selective cutting of the first lumbar dorsal root (L1) , with the aim of also reducing spasticity in the hip flexor muscles. -
Back pain that is less intense and lasts for a shorter period.
According to this team, the approach used allows for lower back pain after surgery to generally be less intense and of shorter duration. -
Earlier start of intensive physiotherapy
One of the advantages mentioned is that it allows the child to resume more intensive physiotherapy and more vigorous physical exercises sooner after surgery.
Hospital website where everything is explained very clearly:
