Selective Dorsal Rhizotomy (SDR)
LOC has developed a reputation in the SDR community for its treatment and management of cerebral palsy patients who have undergone this ground-breaking surgery.
The National Institute for Health and Care Excellence (NICE) guidelines describe SDR surgery: "The aim of selective dorsal rhizotomy is to ease muscle spasticity and improve mobility in people with cerebral palsy. It involves cutting nerves in the lower spine that are responsible for muscle rigidity.” While SDR surgery is not a cure for cerebral palsy, a successful procedure can help a child’s physical state by reducing muscular stiffness and improving mobility.
We feel that SDR offers cerebral palsy patients an opportunity for rehabilitation. It is the first step on a long road of treatment. In our experience, the improvements can be dramatic. However, it is also clear that without continuing rehabilitation SDR patients will not get the maximum benefit from their surgery, and could potentially lose some of the initial improvements they make post operatively.
Orthotics play a vital part in the rehab process. We feel that the alignment of the body needs special attention to allow the physiotherapy, personal training or just the child’s continued mobility to have a significant effect. Gait training and patterning is also essential. Learning patterns of movement at this stage can pay dividends in the future.
In recognition of this we have set up a specialist clinic within LOC called OSKAR. This stands for the Optimal Kinematic Approach to Rehabilitation and is an orthotic method of treating children with lower limb neuromuscular conditions. It was originally developed by Elaine Owen MBE MSc SRP MCSP, a world renowned physiotherapist.
In the OSKAR clinic we dedicate even more time to the initial consultation and utilise our video vector Gait Lab facility. This gives us highly accurate information about the forces that are exerted on a body during the gait cycle. It allows us to prescribe and fit more accurate and objectively-measured orthotics.
We believe that basic orthotic principles still apply, so we always design our orthotics to protect the developing bones of the child. Tuned Ankle Foot Orthotics are especially good for this. However, at LOC, we also use innovative orthotics, sucvh as DAFOs or Dorsiflexion Assist SMOs to improve alignment and gait. We also see good outcomes when we use Dynamic Lycra Garments to address postural problems and improve core stability.
All the time we aim to maximise function, while maintaining alignment. We do not want to over support a joint – we want our patients to have to work their own musculature to maintain stability and posture. However, we also understand that they are often weak and have underlying misalignment. Therefore, we want our orthotics to evolve with our patients – reducing support over time, which requires good communication with parents and other therapists.
Tree of Hope
Some parents who have struggled to fund rehabilitation treatment as well as the original surgery have been helped by the Tree of Hope charity.
Tree of Hope endeavours to provide assistance to families of sick and disabled children trying to raise money for specialist medical surgery, treatment, therapy and equipment. As a small charity, funds are limited, but they do everything they can to help parents achieve their fundraising goals.
The process starts with a telephone or email application from the parent/carer/guardian of the child in need of assistance.
Your case will be assessed on a case-by-case basis. The Tree of Hope will get back to you and hopefully provide the hands-on help and support that is needed.
Just4Children is a recently launched charity whose objective is to provide support to families to help their sick and disabled children. Specifically they will provide support so that families can access quality of life enhancing surgeries and treatments like Selective Dorsal Rhizotomy (SDR). They are currently helping Layla’s family raise £60,000 for the operation and subsequent aftercare. Layla is a 3 year old from Wiltshire who has Spastic Diplegia Cerebal Palsy which affects the use of her legs and left arm.
To find out more: just4children.org
To get in touch:
Peterson’s Fund for Children
Peterson’s Fund for Children’ is a registered local charity that supports children in Surrey who struggle with severe mental and physical disabilities. It has been in existence for 10 years and through extensive fundraising efforts has provided funding for much needed therapy, bespoke and specialised equipment and often neglected respite care otherwise unavailable on the NHS. The aim of the charity is to help as many local children in need as possible therefore improving their quality of life and offering them opportunities to maximise their individual growth and potential.
Contact details: [email protected]