THE ROLE OF SELECTIVE DORSAL RHIZOTOMY IN CEREBRAL-PALSY - CRITICAL-EVALUATION OF A PROSPECTIVE CLINICAL-SERIES

This is a prospective observational study of a consecutive series of 3 4 children with spastic cerebral palsy treated at a single center. 10 had spastic quadriplegia and 24 had spastic diplegia. All were followe d for at least one year. After selective dorsal rhizotomy (SDR), all c hildren received one month of physical therapy at the center and were prescribed a program of physical therapy in their community. The child ren were assessed before and one year after SDR and physical therapy, using the Ashworth Scale, deep tendon reflex response, range of motion and the Gross Motor Function Measure. The results show that there is often a decrease in lower-extremity spasticity and functional improvem ent after SDR with physical therapy, but that there is considerable va riability in outcome. Randomized prospective clinical trials with mask ed objective outcome measures are needed to determine the efficacy of SDR.