Stories about: selective dorsal rhizotomy

Surgery for cerebral palsy

Drs. Shore and Stone discuss cerebral palsy surgery
PHOTO ILLUSTRATION: FAWN GRACEY/BOSTON CHILDREN’S HOSPITAL

When it comes to cerebral palsy (CP) — injury to the developing brain that can affect muscle control, coordination, tone, reflex, posture and balance — parents have a lot of questions about surgical approaches. In fact, selective dorsal rhizotomy (SDR) is a hot topic among physicians and parents alike. This minimally invasive spinal operation can permanently reduce leg spasticity and encourage independent walking in properly selected children with CP. It may be a complementary option along with other therapies, such as physical therapy, systemic medications, Botox injections and orthopedic procedures.

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Spinal surgery for spasticity: How Adam got to like his legs again

Adam Pendergrass used to trip and fall dozens of times a day. “Every pair of pants we have has holes in the knees,” says his mother, Dahlia. “But Adam falls really well. He would stand up, shake himself off and say, ‘I’m OK!’”

At preschool, Adam couldn’t sit crisscross on the floor. He walked with a crouched gait, and to climb the stairs, he had to hold the railing and lift one foot at a time. But none of this was a big deal at first. He knew he had something called cerebral palsy, but it was OK. All the kids at preschool wanted to try his braces and have their legs stretched by the teacher like Adam did. One girl devotedly helped him take off his leg braces at nap time. Adam still gave out hugs and narrated long, action-filled adventures that poured out of his imagination.

Adam’s family had been bringing him from Hartford, Conn., to Boston Children’s Hospital’s Cerebral Palsy Clinic since he was 2 and knew the hospital offered a spinal operation known as selective dorsal rhizotomy (SDR). Adam was an ideal candidate: The operation mostly benefits children with cerebral palsy and leg spasticity who can still walk independently, like Adam could.

However, Adam wasn’t mature enough yet to participate in the rigorous physical therapy that would be needed afterward. So instead, he had weekly physical therapy, hippotherapy (adaptive horseback riding), aquatherapy, gymnastics and Tae Kwon Do, plus Botox injections to relax his leg muscles every few months.

But when Adam turned 5, things were no longer OK.

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