Launch of life-changing operation for children with cerebral palsy

Selective Dorsal Rhizotomy (SDR) is now being performed by a specialist team at Great Ormond Street Hospital (GOSH).

SDR is a minimally invasive procedure that can significantly reduce muscle stiffness in children with spastic diplegic cerebral palsy. The procedure helps children walk more easily, and reduces painful muscle spasms. Eight year-old Niamh from Dundee is the first patient to undergo the surgery at the London hospital.

The introduction of an SDR service at GOSH marks another major milestone for affected children and their families in the UK. SDR can give patients the ability to move without the use of a wheelchair or walking aids for the first time. In recent years, many families from the UK have had to travel to the US for surgery at the Centre for Cerebral Palsy in St Louis, where the minimally invasive SDR technique was pioneered.

The minimally invasive SDR technique was brought to the UK by GOSH neurosurgeon Mr Kristian Aquilina, who treated the first patients at North Bristol NHS Trust in 2011. It is less invasive than alternative techniques and is suitable for children as young as three years old. It involves the selective division of sensory nerve roots arising from the lower spinal cord. Each nerve root is electrically stimulated and the responses from these roots identify those nerves contributing to the spasticity. This process informs the surgeon which nerves to cut.

Mr Aquilina said, “The surgery has already proven to significantly reduce muscle stiffness and give children the ability to stand and walk independently for the first time. The impact on their quality of life and that of their families is therefore enormous.”

“At GOSH, we’re very well placed to offer all the services required to make this treatment a success. Niamh and all the children who follow her will need intense physiotherapy and rehabilitation post-surgery to ensure that they are getting the full benefit of their treatment.”

Spastic diplegic cerebral palsy affects approximately 400 children in the UK each year. It is caused by injury to the developing brain and is often associated with premature birth. Many children have good learning potential, good upper limb function and attend mainstream school.

GOSH is a tertiary specialist hospital for the treatment of children with complex conditions and is therefore in a strong position to care for these children. They require a multidisciplinary team of experts to ensure the best possible outcome, involving neurosurgery, neurodisability, neurophysiology, paediatric orthopaedics and specialist physiotherapy.

Identifying those children who will benefit from SDR requires assessment by a multidisciplinary team. There is high demand for the procedure and the team hopes more children will be treated within the NHS in the future. The team at GOSH is looking forward to collaborating with the existing UK providers, so the long-term benefits of the procedure can be analysed.