Selective Dorsal Rhizotomy at The Portland Hospital
The Portland Hospital is the only private hospital in the UK to offer a Selective Dorsal Rhizotomy service. New to The Portland Hospital for 2014, this procedure is performed by Mr Kristian Aquilina who after training at St Louis Childrens Hospital in St Louis Missouri USA has been performing this surgery since 2011. Within this time he has now performed the greatest number of SDR surgeries in the UK.
Here, we explain what Selective Dorsal Rhizotomy involves and who it may be suitable for.
What is Selective Dorsal Rhizotomy?
Selective Dorsal Rhizotomy is a surgical procedure that has been shown to lead to significant improvement in mobility and quality of life for children with cerebral palsy and spasticity. In these children spasticity typically affects the lower limbs and is known as spastic diplegia. It is this stiffness that makes it difficult for children with cerebral palsy to learn to move and walk.
Selective Dorsal Rhizotomy involves division of some of the nerves in the spine that contribute to patient’s limb stiffness. The patient’s spasticity improves immediately after surgery, and through a period of physiotherapy and rehabilitation, they also begin to show improvements in their movement and gait.
Who is Selective Dorsal Rhizotomy suitable for?
Selective Dorsal Rhizotomy is suitable for children aged three and over with a confirmed diagnosis of cerebral palsy and spastic diplegia.
How will I know if Selective Dorsal Rhizotomy would be a suitable treatment for my child?
At the Portland Hospital we carry out a comprehensive and multidisciplinary assessment to ensure that this procedure is appropriate for the patient. Children are carefully assessed by our team of leading neurosurgeons, paediatricians, physiotherapists and orthopaedic surgeons. During these assessments our consultants will need to review the patient’s medical records, a recent physiotherapy report, an MRI scan of the brain and a recent hip X-ray. The team can also advise you on the procedure’s benefits and risks as well as the expected post-operative physiotherapy the patient may have to undergo.
What does Selective Dorsal Rhizotomy surgery involve?
The three-hour procedure is performed by Mr Kristian Aquilina, a consultant paediatric neurosurgeon with a special interest in spasticity and Selective Dorsal Rhizotomy. The surgery takes place under general anaesthetic and involves identifying and dividing the nerve roots that contribute the most to a child’s spasticity. This is achieved by using a single-level spinal opening technique which is the same technique as that developed in the USA. This technique reduces the risk of spinal instability and the possibility that the child may require spinal stabilising surgery at a later date. It also allows a quick recovery and return to physiotherapy within three days.
After the operation the patient will need to remain in the hospital for approximately 6 more days before undergoing a 14-day intensive physiotherapy programme as an outpatient. The Portland Hospital has facilities available to undertake all continuity of care for the patient including post-surgical rehabilitation.
Are there any other treatments available for children with Spastic Diplegia?
The management of spasticity in children with cerebral palsy is complex. If it is felt that the patient is unlikely to benefit from Selective Dorsal Rhizotomy there are other treatments available that can help reduce limb stiffness and improve mobility. Treatments also available at The Portland Hospital include botulinum toxin injections, physiotherapy, baclofen pump insertion and orthopaedic surgery. Your consultant will be able to explain the risks and benefits of each treatment to ensure that your child is given the most appropriate care.
For more information on Selective Dorsal Rhizotomy or to make an appointment with Mr Aquilina please telephone 020 7390 6384 or alternatively email SDRportland@hcahealthcare.co.uk