Selective Dorsal Rhizotomy
A selective dorsal rhizotomy is a surgical procedure that is used to help remove muscle stiffness (spasticity) in children with Cerebral palsy, after this operation children will require a large amount of intensive physiotherapy to help recover, improve strength and learn to move in a different way. We are based in Lichfield and provide a paediatric physiotherapy service in surrounding areas such as Sutton Coldfield, Tamworth, Rugeley, Cannock and Walsall.
Spasticity is a common side effect of Cerebral Palsy and causes excessive muscle tightness and tension which can lead to reduced range of motion in joints, contractures in muscles and tendons and pain. A selective dorsal rhizotomy reduces this spasticity and is commonly used for children between the ages of 3 and 12. After the operation children will have to learn to use their muscles differently and some weaknesses that were hidden by the spasticity may become apparent and it is essential that your child receives early and intensive physiotherapy intervention.
A selective dorsal rhizotomy is a major operation and involves accessing part of the lumbar spine nerve roots in order to identify the nerves that are responsible for the most spasticity and will require a hospital stay of usually a week. Once your child has been discharged from hospital to home it is vital that they receive regular and intensive physiotherapy sessions with a specialist paediatric physiotherapist who has experience of recovery from this operation. Sessions will involve strengthening of the pelvis, trunk, core musculature, re-establishing balance mechanisms, improving leg strength, improving range of motion at any affected joints and beginning to walk again. This is a lengthy process but it is essential for the recovery of your child that they have access to sufficient physiotherapy and rehabilitation.
How can ThreeSpires Physiotherapy help?
Our paediatric specialist has a large amount of experience of working with children and parents after selective dorsal rhizotomy and will be able to help guide both your child and you through the rehabilitation process. Once you have booked an appointment our paediatric physiotherapist will visit you and your child at home to conduct the initial assessment and treatment session. We always recommend that the initial assessment is conducted at home to make your child feel comfortable, enable a thorough discussion to take place and also to allow our physiotherapist to assess how rehabilitation can take place at home. Follow up sessions may be at home, school or nursery as required. Below is a description of the usual initial assessment procedure:
Subjective - this is a discussion between you, the physiotherapist and depending on their age your child. The physiotherapist will talk over past medical history, protocols or recommendations by the surgeon and goals and anything that you and your child would like to achieve. This is a vital part of the overall assessment as it gives you and your child an opportunity to voice any concerns and allows your physiotherapist to begin to understand how things are going and what is important to you and your child.
Objective - here your physiotherapist will conduct a thorough physical examination of how your child is able to move, range of motion at each joint, balance, strength and overall capabilities. Our paediatric physiotherapist will make this a fun and relaxed process and to your child it may not appear to be an assessment.
Our physiotherapist is an expert at being able to engage children in forms of play that serve to assess a child's strength, balance, function and range of motion at various joints. When working with children this is a vital skill and serves to make each session fun, rewarding and also therapeutic for your child!
Treatment - during the session your physiotherapist will practice various movements, work on strengthening, balance and may also stretch out your child's limbs to improve range of motion. This is always conducted in an entertaining and fun manner in order to maximise engagement and benefit of each session. Your physiotherapist will also discuss and demonstrate ways in which you can help with rehabilitation and exercises at home.
At the end of the initial assessment session your physiotherapist will discuss with you how best to proceed and will talk through an overall plan in terms of number of sessions needed, how often sessions should be, what it is important to work on and initial goals for physiotherapy.
They will also discuss where it is best to conduct each session, initially in the early days after the operation this is likely to be at home but it may well be best to conduct physiotherapy at school. Your physiotherapist (with your permission) will be able to liaise with school, the GP, your surgeon and any other staff involved in the care of your child and can provide a report if required.