What is SDR?
SDR is an operation to Daniel’s spine, which will permanently reduce his spasticity. It will be followed by months of intense physiotherapy to let him learn to work (and hopefully walk!) with his new legs.
SDR stands for Selective Dorsal Rhizotomy. This is an operation in which some of the nerve rootlets of the lower spine are cut, leaving others intact. The surgeon removes the lamina (covering) of a single vertebra and then exposes the nerves below. They split the sensory nerves into sections and test each rootlet to see which are contributing most to the child’s spasticity and which are carrying a more normal signal. Having cut those which rank most highly on this scale, the child should be left with a more normal balance of activity in the spinal column. The entire operation takes about 4 hours.
What did the SDR operation mean for Daniel?
After the operation, Daniel spent about a month in hospital in London, needing both recovery time and intensive physiotherapy. SDR reduced the spasticity in Daniel’s body but he is also very weak, and this weakness is even more apparent immediately after the surgery. Many parents report that their child loses almost all function initially, and has to relearn how to use their body, almost from scratch. With the spasticity removed, Daniel can now learn to move in a more normal pattern, and can start to build up strength. This process takes time, and Daniel will continue to improve for months, maybe even for years, after the surgery.
What about the risks?
There are always risks with any major surgery and SDR is no different. However, leakage of spinal fluid requiring further surgery has only happened in 3 patients out of the more than 2300 treated at St Louis over the years. Other problems have been less serious, and are often transient. The bigger risk is that the surgery may not do what it sets out to do – to permanently reduce Daniel’s spasticity, and improve his functional ability. . Having said that, the team feel that Daniel is an excellent candidate for the surgery and that the permanent reduction in abnormal muscle tone will help him significantly. For this reason, they strongly suggest that Daniel have the rhizotomy surgery.