Enhancement of postural control and upper limb function following selective dorsal rhizotomy: a retrospectively registered study.

UNLABELLED: Cerebral palsy is the most common pediatric disability, characterized by a spectrum of permanent disorders that hinder movement, posture, and overall activity, causing long-term functional limitations. For those unresponsive or unsuitable to conventional treatments, neurosurgical interventions such as selective dorsal rhizotomy or intrathecal baclofen may be considered. Selective dorsal rhizotomy (SDR) aims to reduce lower limb spasticity while preserving sensory and sphincteric functions. Despite its established effectiveness in the control of lower limb increased muscle tone, its impacts on the upper limb motor performance and the trunk control require further investigations. This study aims to systematically assess changes in neck, trunk, and upper limb functionality following Selective Dorsal Rhizotomy in children with cerebral palsy, highlighting the improvements and the timeline of recovery after surgery.

CONCLUSIONS

Selective dorsal rhizotomy improvements achieved are significant especially in the early post-surgical phase and already detectable three months after surgery and involved also a reduction in both upper limb function and trunk misalignment. Determining post-operative improvements and recovery times can help maximize post-operative outcomes through appropriate rehabilitation therapies.

WHAT IS KNOWN: • Selective dorsal rhizotomy (SDR) aims to reduce lower limb spasticity while preserving sensory and sphincteric functions, but limited research exists regarding the impact of SDR on the improvement of upper limb function and trunk control.

WHAT IS NEW: • This study reveals key insights into changes in neck, trunk, and upper limb function post-SDR in children with CP, identifying which parameters improve, and the timeline of these improvements. Our findings suggest how age at surgery have an impact on the short-term improvement on the upper-limb movements, shedding new light on the importance of fine-tuning appropriate rehabilitation protocols.