After SDR Surgery: What Can You Expect?
The selective dorsal rhizotomy surgery typically takes around four hours. After it’s over, many patients notice increased skin sensitivity on the legs and feet. This is a completely normal response to the manipulation and severing of certain nerves and usually disappears within the first month and a half. Other less serious complications include spinal fluid leakage, temporary changes in bladder function, and infections at the site of the surgery. Meningitis is also possible. More serious complications, which are fortunately very rare, are impotence, leg paralysis, bladder paralysis, and permanent loss of sensation in the affected areas. Most of these things can be avoided by careful monitoring during the patient’s stay in the hospital, coupled with enough bed rest to assist with the healing of the incision. Antibiotics are also commonly used to prevent infection.
In the initial days and weeks after the surgery, of course the patient will feel weaker, but even so, the spasticity will be noticeably reduced, allowing him or her to begin building stronger muscles almost immediately through an intensive course of physical therapy. Patients feeling discouraged should note that the surgery itself doesn’t create the weakness, it just exposes the underlying weakness that couldn’t be seen due to the spasticity. Within several weeks, the patient should be back to his or her typical level of ambulation and movement as before the surgery, and then that can be used as the base from which to improve.
According to a recent study done at McGill University in Montreal, Quebec, Canada, the long-term outcomes of SDR surgery show a statistically significant improvement that is long lasting, one that reduces the need for further interventions like orthopedic surgery or Botox injections in many patients. This important study is the first one of its kind published, the first one to look at long-term effects of SDR surgery based on patient stratification and validated assessments of said patients’ abilities pre- and postoperatively. You can read a thorough write-up of the details of the study here. Long-term benefits of selective dorsal rhizotomy in children with spastic cerebral palsy.
As the study from McGill suggests, arguably the biggest benefit of SDR surgery is that the spasticity doesn’t recur. It is therefore the only permanent solution currently available for spastic cerebral palsy. There are of course other significant potential benefits, including positive effects on motor function and deformities, and improvements to cognition and speech; check out this list presented by St. Louis Children’s Hospital here for more information. About Selective Dorsal Rhizotomy (SDR)
Last but not least, if you’re struggling with the decision of whether or not to undergo SDR surgery, either yourself or for your child, United Cerebral Palsy has a wonderful, brief discussion of the proceduce, New Evidence on Outcomes of Selective Dorsal Rhizotomy, and a checklist of things to consider. SDR Surgery in the United States and the United Kingdom