Selective Dorsal Rhizotomy

When your child lives with cerebral palsy, muscle spasticity can significantly impact their daily life. Tight, stiff muscles make walking and movement difficult, cause pain, and limit independence. For many families, Selective Dorsal Rhizotomy (SDR) offers hope for a more comfortable, mobile future.

Understanding How SDR Works

Children with cerebral palsy often experience overactive sensory nerve roots in their spinal cord. These nerve roots send excessive signals to muscles, causing the characteristic spasticity, stiffness, and pain that many parents recognize in their children.

During the SDR procedure, our surgical team carefully identifies these overactive nerve roots and selectively cuts only the most problematic ones. This targeted approach reduces spasticity while preserving the nerve pathways essential for normal movement and sensation. The result is improved muscle control, less pain, and significantly reduced stiffness.

Our Minimally Invasive Surgical Approach

At Neurosurgeons of New Jersey/NYU Neurosurgery Network, we perform SDR surgery through a single-level laminectomy, which represents a significant advancement over traditional methods. While most surgeons use large back incisions, our minimally invasive technique offers several advantages:

• Smaller incisions with less tissue disruption
• Reduced post-operative pain and faster healing
• Shorter hospital stays for your child
• Less noticeable scarring as your child grows

Your child will be under general anesthesia throughout the procedure, ensuring they remain comfortable and pain-free. Most children stay in the hospital for just a few days for observation and initial recovery.

This minimally invasive approach distinguishes our practice from others throughout New Jersey and across the country, giving families access to the most advanced surgical techniques available.

Is Your Child a Candidate for SDR?

Not every child with cerebral palsy benefits from this surgery. The decision requires careful evaluation by our multidisciplinary team, which includes specialists in neurosurgery, orthopedics, physical medicine and rehabilitation (physiatry), neurology, orthotics (bracing, etc.), equipment (wheelchair, etc.), and social work.

We typically see the best results in children who:

• Are between 2 and 18 years old
• Have spastic diplegia (primarily affecting the legs), hemiplegia (affecting one side of the body), or spastic quadriplegia (affecting arms and legs)
• Experience significant muscle spasticity that limits mobility and quality of life
• Have good underlying strength and cognitive abilities
• Haven’t responded adequately to other treatments like physical therapy, medications, or injections

The Comprehensive Evaluation Process

Before recommending surgery, we conduct a thorough assessment that includes:

• Comprehensive history
• Detailed neurological examinations
• Gait analysis to understand walking patterns
• Muscle strength and flexibility testing
• Advanced imaging studies
• Psychological and developmental evaluations

This comprehensive approach ensures we only recommend surgery for children who will truly benefit from the procedure.

What to Expect: Recovery and Rehabilitation

The success of SDR depends heavily on what happens after surgery. Intensive physical therapy begins two days after the procedure and continues for months afterward. Our rehabilitation team works closely with each child to:

• Rebuild muscle strength that may have been limited by spasticity
• Develop new movement patterns with reduced muscle tension
• Improve balance and coordination
• Enhance independence in daily activities

Why Choose Dr. Richard Anderson and Our Team

Dr. Richard Anderson brings over 25 years of expertise to pediatric neurosurgery, with a particular specialization in procedures that reduce spasticity. He acts as Clinical Professor at NYU and Director of Pediatric Neurosurgery at Morristown Children’s Hospital, Valley Hospital, and St. Joseph’s Children’s Hospital. As one of the top pediatric neurosurgeons in the Tri-State region, he has:

• Over 250 publications and invited lectures
• Recognition as one of America’s Top Doctors
• Extensive experience with minimally invasive techniques
• A patient-centered approach that prioritizes your child’s comfort and outcomes

Our practice serves families throughout New Jersey and New York, with convenient locations in Ridgewood, Morristown, Manhattan, and Paterson. We work with most insurance plans and have specialists on staff to help navigate coverage questions.

Making the Right Decision for Your Family

Choosing surgery for your child is never easy. We understand the anxiety and hope that come with considering SDR. Our team takes time to answer all your questions, explain the procedure in detail, and help you understand realistic expectations for your child’s specific situation.

While SDR can be transformative for many children, it’s not the right choice for everyone. We also discuss alternative treatments, including:

• Physical and occupational therapy
• Medication management
• Botox or other injections
• Orthopedic interventions
• Intrathecal baclofen pump
• Combination approaches

Taking the Next Step
If you believe your child might benefit from SDR, we encourage you to schedule a consultation. During this comprehensive evaluation, we’ll assess your child’s specific condition, discuss potential benefits and risks, and answer all your questions about the procedure and recovery process.

Our commitment to minimally invasive techniques, combined with Dr. Anderson’s expertise and our comprehensive care team, provides families with the best possible outcomes. Many children experience life-changing improvements in mobility, comfort, and independence.

About Dr. Richard C.E. Anderson, MD, FACS, FAAP

Dr. Richard Anderson is recognized as one of the top, award-winning pediatric neurosurgeons in the Tri-State region. He practices out of Neurosurgeons of New Jersey’s Central and North Jersey locations, including the Ridgewood, Morristown, Manhattan, and Paterson offices. Utilizing the most innovative and proven technology, Dr. Anderson specializes in the treatment of pediatric brain and spinal disorders through minimally invasive surgeries and complex procedures when necessary. With over 250 publications, invited lectures, TV, and magazine interviews, Dr. Anderson is consistently named one of America’s Top Doctors, America’s Top Surgeons, Favorite Kids’ Doctors in NJ, and a recipient of the Patient’s Choice Award. He is currently accepting new patients.

FAQs

How long does the surgery take?

The procedure typically takes around 4 hours, depending on your child’s specific needs and anatomy.

Will my child be able to walk better after surgery?

Most children experience improved walking ability, though individual results vary based on pre-surgical function and commitment to rehabilitation.

What are the risks?

As with any surgery, there are risks, including infection, bleeding, and temporary weakness. Our minimally invasive approach significantly reduces these risks compared to traditional methods.

How soon can my child return to normal activities?

Most children return to school and resume full activities within 2-4 weeks, depending on their progress in healing.

Is the procedure covered by insurance?

SDR is a medically necessary procedure that is covered by the vast majority of insurances.. Our insurance specialists help families navigate the approval process.