Before and After Surgery for Movement Issues: Preparing for and Recovering from Selective Dorsal Rhizotomy (SDR)
Selective Dorsal Rhizotomy (SDR) is a surgical procedure aimed at reducing spasticity (muscle stiffness) in children with cerebral palsy and other neurological conditions that affect movement. This procedure involves cutting nerves in the lower spine that are responsible for muscle rigidity, thereby improving mobility and reducing discomfort. Proper preparation and post-surgical care are critical to maximize the benefits of this procedure.
Preparing for Surgery
Pre-surgical preparation is vital for ensuring the best outcomes from SDR. This preparation involves:
- Physiotherapy Evaluation: A thorough assessment by a Paediatric physiotherapist to determine the child’s baseline muscle tone, strength, and range of motion. This evaluation helps in setting realistic post-surgery goals.
- Strengthening Exercises: Tailored exercises to strengthen muscles that will be important for post-surgery recovery and mobility.
- Family Education: Informing and training family members on post-surgery care, including potential needs for equipment and home modifications.
The SDR Procedure
SDR is typically recommended for children who have significant spasticity that interferes with mobility and daily activities. The surgery involves identifying and severing nerve roots that contribute to spasticity, allowing for more normal muscle movements and reducing pain associated with overactive nerves.
Post-Surgical Rehabilitation
After SDR, rehabilitation is crucial and begins almost immediately. The goals of post-surgical physiotherapy include:
- Regaining Mobility: Initial exercises focus on gentle movements to improve flexibility and gradually increase range of motion.
- Strengthening: As healing progresses, more intensive exercises are introduced to build muscle strength and support new movement patterns.
- Gait Training: Specialized training to improve walking patterns, balance, and coordination.
- Functional Skills Development: Activities and exercises designed to integrate improved muscle function into everyday tasks.
Long-Term Care and Follow-Up
Recovery and improvement are ongoing processes that can extend months or even years after surgery. Long-term care may involve:
- Routine Physiotherapy Sessions: Ongoing therapy to continue improving strength and mobility.
- Regular Assessments: Periodic evaluations to adjust therapy goals as the child grows and develops.
- Support for Families: Continued education and support for families to help them adapt to changes in their child’s abilities and needs.
Conclusion
SDR can significantly enhance the quality of life for children with severe spasticity, but success greatly depends on careful preparation and committed post-surgical rehabilitation. With the support of a dedicated Paediatric physiotherapy team, children can achieve greater independence and participate more fully in life’s activities.