Background Purpose: Selective Dorsal Rhizotomy (SDR) is a common surgical procedure that pediatric patients with spastic cerebral palsy (CP) undergo with the intention to improve function. The goals of this case are to investigate pre-intervention strategies and demographics that may relate to better outcomes, the procedure itself, and expected short and long term functional outcomes. A major component of this literature is to compare this patient's case to research and also to help clinicians be better informed on the procedure's successes, failures and recommendations as to who would best benefit from the procedure. Case Description: This case began with an initial evaluation of a 2 year and 8 month old boy referred to PT by his primary pediatrician to address impairments and functional limitations caused by cerebral palsy. At the child's age of 3 years and 2 months, the family of the patient elected to undergo SDR. At that time, a new referral to PT was designed to address post SDR protocol from St. Louis Children's Hospital in St. Louis. The goal of this case study was to address clinical changes measured within a physical therapy setting from the initial evaluation to the age of 3 years and 10 months, or 8 months post SDR. Outcomes: The outcomes measured are the Growth Motor Function Classification System (GMFCS), Gross Motor and Functional Measure (GMFM), lower extremity range of motion (ROM), Modified Ashworth, Gait speed, and functional abilities. Discussion: SDR is a common procedure that began over 100 years ago. It was not until the late 1970s that it had resurgence as a popular CP intervention to reduce spasticity and increase functional abilities. There continues to be ongoing discussions today as to the efficacy and possible side effects of the intervention. The ongoing body of research, although low in quality, generally presents as a positive technique with minimal side effects. This particular case tends to align itself with the positive research that indicates functional gains and reductions in impairments measured in the short term with SDR in combination with post-operative physical therapy rehabilitation.
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Selective Dorsal Rhizotomy, pediatric, physical therapy
Donnellan, Brian. "Capstone Project — Case Report and Evidence Based AnalysisSelective Dorsal Rhizotomy." (2014). http://digitalrepository.unm.edu/dpt/28