Effect of selective dorsal rhizotomy on neuromuscular symptoms, muscle morphology, and motor function in children with spastic cerebral palsy

Abstract

This study looked at changes in neuromuscular symptoms (spasticity, range of motion, strength, selectivity), muscle growth, and motor function (gait and gross motor function) before and 1 year after selective dorsal rhizotomy (SDR) in children with spastic cerebral palsy (SCP). SDR is a permanent tone-reducing modality that is often applied with these children. During the SDR procedure, 25% to 30% of the dorsal rootlets were cut, descending between L1 and S1 (on the spine). Children received an intensive rehabilitation program during the year after the procedure, with the goal to optimize their quality and quantity of movement.

Fifteen children with bilateral SCP, with a median age of 8 years 8 months, participated in the current study. The study group consisted of 11 boys and 4 girls. Eight children were classified in Gross Motor Function Classification System (GMFCS) level II (children walk in most settings and climb stairs holding onto a railing) and seven were in GMFCS level III (children walk using a hand-held mobility device in most indoor settings). The results showed that SDR effectively reduces spasticity, without negatively affecting muscle growth in children with SCP. Moreover, SDR creates potential beneficial circumstances, namely reduced spasticity and improved selectivity and gait, which may potentially facilitate muscle growth.