Why is this procedure done?
Children with cerebral palsy often have very stiff muscles. This is called spasticity. Your child may have muscle stiffness in the arms, legs, or trunk. Because of the muscle stiffness, your child may have problems with walking. The stiffness can limit how fast your child is able to walk and how well your child is able to move the legs. If the stiffness keeps up, it can lead to lasting muscle and bone problems. ‚
Muscles normally have some stiffness. This is called muscle tone. The muscles send signals through nerves to the spinal cord to keep up this tone. At the same time, the muscles also are getting signals to relax. These signals move from the brain through nerves to the spinal cord. With muscle spasms, the brain may not be able to send out enough signals to get the muscles to relax. Then, there is too much muscle tone or spasticity. ‚
Selective dorsal rhizotomy is also called SDR. It is one way to treat the muscle spasms. This surgery helps to balance the signals sent from nerves from the spinal cord to the muscles that give muscle tone. The doctor cuts some of the nerves that are in charge of muscle tone. This helps to balance the signals for tone and for relaxing. SDR helps to relax muscles. It may lower chronic pain in the arms or legs. SDR can also help to fix an overactive bladder. ‚
What will the results be?
This surgery will help your child have more normal muscle tone. Then, your child may be able to move about more easily. ‚
What happens before the procedure?
- The doctor will take your childs history. Talk to the doctor about:
- All the drugs you are giving your child. Be sure to include all prescription and over-the-counter (OTC) drugs, and herbal supplements. Tell the doctor if your child has any drug allergy. Bring a list of drugs your child takes with you.
- Any bleeding problems. Be sure to tell your doctor if you are giving your child any drugs that may cause bleeding. Some of these are Coumadin ‚ ®, ibuprofen, Aleve ‚ ® (naproxen), or aspirin. Certain vitamins and herbs, such as garlic and fish oil, may also add to the risk for bleeding. You may need to stop these drugs as well. Talk to your doctor about them.
- The doctor will do an exam on your child and may order:
- Lab tests
- X-rays
- Physical therapy
- MRI
What happens during the procedure?
- You may be allowed to go into the operating room until your child goes to sleep.
- Once in the operating room, a drug will be given to make your child sleepy. It will also help your child stay pain free during the surgery. The staff will put an I.V. in your childs arm to give fluids and drugs.
- When your child is asleep, the doctors put a tube in the mouth to help your child breathe. Your child may have a tube in the bladder to drain urine.
- The doctor will make a 2 to 3 inch long cut over the center of the lower back, just above the waist. The doctor may take out a small amount of bone. The nerves leaving the spinal cord are very carefully identified and divided into sections. The abnormal ones are cut and the others are left intact.
- The doctor will close the cut with stitches or glue and cover it with clean bandages.
- The surgery takes about 3 to 4 hours.
What happens after the procedure?
- Your child will go to the Intensive Care Unit (ICU) after surgery. The staff will watch your child closely and give your child drugs for pain.
- Your child will be turned from side to side every few hours for the first day or so. By the third day after surgery, your child will begin to get out of bed to a chair.
- Your child will continue to have physical therapy (PT). Activity will be based on what your child can tolerate. There will be restrictions on keeping your childs back straight.
- You will be able to take your child home when you are comfortable helping your child and working with the PT program.
What drugs may be needed?
The doctor may order drugs to: ‚
- Prevent infection
- Help with pain
- Ease muscle spasms
What problems could happen?
- Infection
- Bleeding
- No change in muscle tone
- Nerve damage, such as change in toilet habits that does not go back to normal for your child
- New weakness in muscles
- Loss of feeling, numbness, or uncomfortable sensations in lower legs
Where can I learn more?
National Institute of Neurological Disorders and Stroke ‚
http://www.ninds.nih.gov/disorders/cerebral_palsy/detail_cerebral_palsy.htm#179363104 ‚
Consumer Information Use and Disclaimer
This information is not specific medical advice and does not replace information you receive from your health care provider. This is only a brief summary of general information. It does NOT include all information about conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or life-style choices that may apply to you. You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care providers advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you. ‚
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Copyright ‚ © 2015 Clinical Drug Information, LLC and Lexi-Comp, Inc. ‚