Surgical innovations hold the power to transform lives, especially for children navigating challenges like cerebral palsy (CP). Selective dorsal rhizotomy (SDR) is a surgery that has long been recognized as an effective treatment for spasticity in CP.
However, its potential for treating hemiparetic spastic CP specifically due to intraventricular hemorrhage (IVH) brain damage had previously remained underexplored.
A recent study sought to bring clarity to this question. Researchers conducted an analysis on 11 children diagnosed with hemiparetic CP due to IVH who had already undergone SDR surgery between 2017 and 2023.
Doctors first categorized each case based on the degree of IVH brain damage severity. Then they compared the results of key functionality indicators both before surgery, then at the 6 month and 1 year mark following SDR surgery.
Among these, they measured the Gross Motor Function Classification System (GMFCS), Modified Ashworth Scale (MAS), and key motor skills like sitting, standing, and walking. The study also explored the relationship between IVH severity and surgical outcomes.
Remarkably, each participant achieved complete elimination of spasticity after the procedure, with MAS scores dropping to zero post-surgery. Yet, changes in GMFCS levels were minimal, showing notable improvement in only one patient.
However, the true significance lay in functional motor gains. All children showed sustained improvements in practical motor tasks, including sitting, standing, and walking, without regression or recurrence at both the 6 and 12 month mark following surgery. Most importantly, no adverse events occurred.
Interestingly, the severity of IVH brain damage did not significantly affect the Motor Function outcome scores or the improvements after surgery. This would suggest that the benefits of unilateral SDR are consistent regardless of the initial severity of brain damage.
These findings point to unilateral SDR as not only safe but exceptionally beneficial for reducing spasticity and enhancing motor function in children with hemiparetic CP resulting from IVH. While these results are encouraging, further larger-scale studies are essential to reinforce and broaden our understanding of SDR's full potential.
Through thoughtful surgical intervention, we step closer to unlocking independence and improved quality of life for children affected by cerebral palsy.
Sources:
Sarikaya-Seiwert S, Clauberg R, Hainmann I, et al. Impact of Unilateral Selective Dorsal Rhizotomy (SDR) on Spasticity and Motor Function Improvement in Children With Hemiparetic Cerebral Palsy Caused by Intraventricular Hemorrhage. Cureus. (May 7, 2025).
Retrieved from https://www.cureus.com
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