Selective Dorsal Rhizotomy (SDR) referrals

NHS Greater Glasgow & Clyde offers a surgical treatment called Selective Dorsal Rhizotomy (SDR) to patients across Scotland and can consider referrals from further afield.

Selective Dorsal Rhizotomy (SDR) is a complex neurosurgical technique developed to reduce spasticity and improve mobility in patients with cerebral palsy and lower limb spasticity.

It involves the irreversible selective division of dorsal (sensory) rootlets as they emerge from the conus medullaris of the spinal cord.  These nerve roots make up the afferent (input) limb of the reflex arc that is exaggerated in spasticity.  The procedure takes place under general anaesthesia using intra-operative neurophysiology.

Each local area will have a form of multidisciplinary team managing complex motor disorders and children with spasticity. These multidisciplinary (MDT) teams should discuss children potentially suitable for SDR and assess if they fit the referral criteria. If the local MDT agrees, the child should be referred via the electronic referral form.

Realistic outcomes and the limitations of all therapies should be discussed with the family as SDR may not be the “miracle cure” some families expect. Families also need to be aware of and agree to an increased programme of home exercises following the procedure.

More information about the referral process and other information about SDR can be found on our area of the Right Decision Service.