What does SDR surgery involve?

The surgery requires the bones of the spine (vertebrae) in the lower back area to be opened to reveal the conus (the end of the spinal cord) and gain access to the nerve roots. The traditional approach was to access these roots via a lengthy multi-level operation gaining access to the nerves by opening several vertebrae. However, some evidence suggests the multi-level approach may lead to other spinal problems such as scoliosis (curvature of the spine).

A less invasive single-level approach where only one vertebra is opened has been developed by Dr TS Park at the St Louis Children's Hospital in America and is now increasingly available in the UK.

The abnormal nerve roots causing the spasticity are identified by electrical stimulation. The nerves not "transmitting" effectively are partially cut. Due to the size of the nerves, this is a complex, precise procedure with surgery lasting several hours and will require your child receiving a general anaesthetic.

Following surgery, your child will normally be in an intensive care or high dependency unit for up to 48 hours before returning to the ward. With the single-level surgery, your child will be mobilised from the third post-operative day. This increases to five to 10 days with the multi-level approach.

For SDR to be effective, it is vital that intensive physiotherapy is available and commences as soon as your child is mobilised. In the UK and with the single-level approach, patients are usually hospitalised for up to four weeks. This enables them to have this initial physiotherapy before discharge. On-going physiotherapy and home exercise programmes can be required for up to two years. Without physiotherapy, SDR surgery will prove ineffective.

"It was hard work during the first few physio sessions but he was walking within two weeks." Parent