Selective Dorsal Rhizotomy/Baclofen Pump
A common characteristic of various neurological disorders is spasticity, which is the excessive tightness or tension of certain muscle groups. It interferes with smooth, coordinated motions, and results in limited movement patterns and impaired motor skills. Selective dorsal rhizotomy (SDR) and the Baclofen pump are two treatments for spasticity that may help reduce muscle tension.
SDR is a spasticity treatment that reduces spasticity in the lower extremities. Through this procedure, certain hyperactive sensory rootlets coming from the muscles are cut. Interrupting these abnormal pathways from the muscle reduces abnormal sensory input. Selective dorsal rhizotomy strives to restore balance between the sensory information and the motor responses.
An SDR team evaluates children being considered for surgical treatment, via a selective dorsal rhizotomy or the Baclofen (a drug that reduces spasticity) pump. The Baclofen pump is surgically implanted under the abdominal skin with a catheter inserted into the spinal canal and requires regular maintenance.
Children able to walk alone or with braces, walker, or crutches may be videotaped. Each team member will examine the child. The group will then meet to discuss which procedure will be in the child's best interest. The surgeon will discuss with the family the risks and the potential benefits and if surgery is scheduled, the clinical nurse specialist will assist in obtaining equipment and coordinating therapies.
While neither of these spasticity treatments - selective dorsal rhizotomy or the Baclofen pump - will eliminate the underlying neurological problem (e.g. Cerebral palsy), reducing the spasticity may allow better muscle control and function. Therapy will also be essential before and after surgery.