Selective Dorsal Rhizotomy

This procedure is offered to select patients with spasticity resulting primarily from cerebral palsy who may not be ideal candidates for other types of surgical intervention. The surgery is performed through a lumbar laminectomy which allows for exposure of the collection of nerve roots (cauda equina) emanating from the tip of the spinal cord (conus medullaris). These motor and sensory nerve roots innervate the lower extremities as well as allowing for continence of bowel and bladder. Neurophysiological monitoring and intra-operative EMG differentiate sensory from motor nerve roots. The surgeon then selectively cuts a proportion of the sensory nerve roots thereby diminishing a sensory-motor feedback loop which potientiates increased muscular tone and spasticity.