Combined dorsal and ventral rhizotomy in non‐ambulatory individuals with mixed spastic bilateral cerebral palsy: A prospective registry analysis

Children with cerebral palsy (CP) with more severe motor impairment often have stiff muscles (spasticity) and muscles that tighten uncontrollably (dystonia). These symptoms can be uncomfortable, make everyday care harder, and lower quality of life. When the condition proves resistant to standard medical or drug treatments, surgical intervention can be considered. One traditional option is a baclofen pump: a device placed under the skin that delivers medicine to the fluid around the spinal cord. However, these pumps have a high complication rate and need frequent care. This study looked at a one-time operation called combined dorsal and ventral rhizotomy which does not require any hardware placement. In this surgery, the surgeon divides nerve roots to quiet the overactive sensory and motor signals that cause stiffness and tightness. We studied 33 patients who had this operation at a large children's hospital in the USA. Nearly all patients had severe motor impairment and could not walk. The surgery is usually safe, with few complications. Both spasticity and dystonia improved immediately after surgery and remained improved a year later. Importantly, families also reported an improved quality of life. In addition, at 1 year after surgery, no child had lost the ability to stand or use a walking aid.