Long-Term Outcome of Selective Dorsal Rhizotomy for Spastic Children

Abstract

Given the concerns associated with the ageing process in adults with cerebral palsy (CP) and the significant number of children who have undergone selective dorsal rhizotomy (SDR) in the recent decades, there is an important clinical need to evaluate both the short- and long-term impacts of this invasive and irreversible neurosurgical procedure. To gain insight in the health condition, the International Classification of Functioning, Disability and Health (ICF) model was used. The ICF serves as a biopsychosocial model for evaluating individuals with disabilities, providing a comprehensive perspective that encompasses understanding both the 'body structure and function' of individuals and determining the level of 'activity and participation' within the community. Furthermore, this review incorporates the dimension 'quality of life' as an essential factor to be discussed in relation to the outcomes of SDR. Based on a narrative literature review, this chapter outlines the outcomes observed at 5-15 years and 15-25 years post-SDR. Additionally, insights into outcomes beyond 25 years after SDR have been provided, drawing on the experiences of the Cape Town research group in South Africa, where SDR was reintroduced on a large scale by Warwick Peacock in the 1980s. The chapter concludes with a discussion on complications following SDR. This review will provide the clinical community and parents with information about the short- and long-term outcomes of this neurosurgical intervention.

Keywords: Cerebral palsy; Complications; Dorsal rhizotomy; ICF model; Long-term outcomes; Quality of life; Short-term outcomes.