Selective Dorsal Rhizotomy (SDR) for Spasticity
Selective dorsal rhizotomy (SDR) is a neurosurgical treatment for selected spasticity patterns, reducing abnormal sensory input to improve tone, comfort, and function.
Spasticity and neurorestoration pathway
From tone and function assessment to recovery strategy
Function review
Assess injury type, tone pattern, remaining strength, sensation, disability, and rehabilitation history.
Goal definition
Define the goal, such as comfort, positioning, arm use, hand control, independence, or disease-modulation strategy.
Option matching
Compare baclofen pump, SDR, paired VNS, VNS for RA, nerve transfer, ReActiv8, or research pathways.
Procedure planning
Plan the implant, rhizotomy, stimulation therapy, or reconstruction only when candidacy, timing, and goals align.
Rehabilitation
Coordinate recovery, therapy, programming, outcome tracking, and long-term follow-up.
Function-focused
Planning starts with tone, comfort, remaining function, and realistic recovery goals.
Technology-aware
Established therapies, emerging devices, and research pathways are separated clearly.
Rehabilitation-linked
Surgical and device decisions are coordinated around therapy participation and follow-up.
Overview
Selective dorsal rhizotomy (SDR) is a surgical treatment for selected patients with spasticity. It reduces abnormal sensory input that contributes to increased muscle tone.
When it may be considered
SDR may be considered when spasticity interferes with function, positioning, comfort, hygiene, or care, and when evaluation suggests that reducing selected sensory input would help.
Evaluation
Evaluation includes neurologic exam, therapy assessment, functional goals, gait or movement assessment when appropriate, and comparison with other options such as intrathecal baclofen pump therapy.
What to expect
SDR requires careful rehabilitation planning. The goal is not simply to reduce tone, but to improve comfort, care, movement, or long-term function.
Dr. Barone’s approach
Dr. Barone evaluates SDR as part of a broader spasticity surgery toolkit, comparing it with baclofen pump therapy, selective neurotomy, neuromodulation, and rehabilitation goals.
Frequently asked questions
What is selective dorsal rhizotomy? +
SDR is a procedure that selectively divides sensory nerve rootlets contributing to spasticity, with the goal of reducing abnormal tone while preserving useful function.
Who may be a candidate? +
Candidates are selected carefully based on spasticity pattern, strength, function, diagnosis, therapy goals, and whether reducing tone is likely to improve care or movement.
Is SDR the same as a baclofen pump? +
No. SDR is a lesioning procedure that permanently reduces selected sensory input. A baclofen pump is adjustable medication delivery. The right option depends on the patient.
Considering treatment for Spasticity?
Dr. Barone evaluates new patients and referrals at Houston Methodist Hospital, Houston. Patients from outside Houston, across the United States, and internationally are welcome.