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Key Considerations for Selective Dorsal Rhizotomy for Cerebral Palsy

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Explore the Details, Benefits, and Potential Risks of Selective Dorsal Rhizotomy Treatment for Spastic Cerebral Palsy

According to the Centers for Disease Control and Prevention, cerebral palsy (CP) is a movement and balance disorder affecting the muscles, which may be weak, uncoordinated, or stiff, and is one of the leading childhood motor disabilities. Spastic CP is the most common of the four types of CP and is notable for muscle stiffness and tightness in the legs, arms, trunk, or face, depending on the type of CP. Muscle stiffness in the legs may hinder walking, and if one side of the body’s muscles is stiff, balance is challenging. The most extreme form of CP affects all four limbs, face, and body, among other sensory and cognitive disabilities.

Muscle stiffness results from a miscommunication or lack of communication between the brain and nerves. When increasing muscle stiffness and spasms plague a child, known as spasticity with dystonia, pediatric surgeons may recommend a treatment to alleviate some of the muscle pain and stiffness. Selective dorsal rhizotomy (SDR) is a surgical procedure that involves cutting away dysfunctional nerves from the spine to relieve pain and stiffness and improve movement.

About Selective Dorsal Rhizotomy

The procedure requires that the patient is asleep, so an anesthesiologist administers anesthesia through an IV. The surgery takes about four hours, after which the child remains in the recovery room for another two hours. The hospital stay lasts for about three weeks, rotating from intensive care to the neuroscience unit and, finally, to in-patient rehabilitation. During the procedure, the surgeon opens the vertebra at the back of the spine, followed by nerve root testing to find the sensory nerves that need disconnection. The surgeon examines the nerve activity using electromyography (EMG) to find the spasticity-causing sensory nerves. The surgeon also installs a pump that releases spasticity-relieving medications that need regular refilling and pump replacement after five years. The nerve root cutting and the pump aim to improve the neurological connection between the spine and muscles, reducing stiffness.

Advantages of Selective Dorsal Rhizotomy for Muscle Spasticity from Cerebral Palsy

SDR benefits children with CP by improving mobility and lessening muscle tightness and pain. CP patients with affected lower limbs and some walking ability, even if assisted with a device, benefit most from this surgery. Those children with spasticity in the legs and feet who can walk, even with a cane, are often primary candidates for this surgery. They may respond better to the surgery, with better muscle control over the lower limbs, enabling them to do more strength and cardiovascular exercises they may not have been able to do before. Other gradual improvements that evolve over the six months and beyond after surgery include improved upper-body muscle coordination, speech, mood, potty training, and intellectual development. After SDR, a patient may also see improvement in CP-related limb issues, such as foot deformities, hip subluxation, and contracted hamstrings.

Other treatment methods include orthopedic surgery to cut muscles and tendons loose to relieve spasticity. However, the patient often loses muscle strength and may need multiple surgeries. On the other hand, SDR permanently severs nerve roots so that greater mobility and reduced stiffness continue indefinitely while preserving muscle strength. Thus, only one surgery is necessary.

SDR may be an invaluable pain-relieving, life-improving procedure for children with CP with lower limb spasticity. Since CP is a life-long condition arising from brain damage or brain congenital deficiencies affecting movement and coordination, SDR is often considered a necessary treatment for eligible children.

Understanding the Risks of SDR for a Child

As with all surgeries, SDR can result in infection, inflammation, bleeding, and an allergic reaction to anesthesia. In addition, spinal cord surgery is risky for spinal fluid leaks, bladder defects, leg numbness, leg or foot skin sensitivity, bladder control loss, and spinal deformity development. Severe spasticity may not reduce after the surgery, and orthopedic surgery may eventually be necessary when other therapeutic means, like stretching and splints, do not provide relief.

Where Cerebral Palsy Often Comes From

CP occurs most often from oxygen deprivation, which causes brain damage. Hypoxia, or oxygen deprivation, may be the result of prematurity, protracted labor, undetected fetal distress, or a prolapsed umbilical cord. When the umbilical cord drops into the birth canal before the baby during delivery, oxygen is cut off from the fetus. However, maternal infections may also cause CP. Thus, a neglected infection during pregnancy may also cause CP.

Negligence by a Medical Provider and the Connection to Cerebral Palsy

Medical malpractice may be the cause of hypoxia, untreated maternal infection, and prematurity when a physician’s medical practices deviate from the norm. Standard methods by obstetricians exist to test for maternal conditions, prolong a pregnancy at risk for prematurity, monitor a baby during delivery, and anticipate complications. Failing to follow those practices results may constitute medical malpractice that causes CP.

In New Jersey, patients have the right to redress wrongs to them or their loved ones for injuries caused by negligent medical practitioners. Medical malpractice claims for damages seek compensation for those injured by medical professionals who fail their patients by not following proper protocols. Compensation includes payment for past, present, and future medical expenses due to doctor visits, hospital stays, surgeries, therapists, medical devices, adaptive devices, tutors, and other costs of raising a child with CP.

Compensation includes other economic and non-economic damages, like pain, suffering, and psychological trauma. Parents of children with spastic CP often suffer witnessing their beloved child struggling with painful, debilitating spasticity. And the costs of SDR, ongoing therapy, and medical visits to refill medication or replace medicine pumps add up over the life of a child.

Let our New Jersey Attorneys Review Your Case and if Possible, Seek Compensation for Your Child’s Medical Needs

If your child has CP you suspect is a birth injury that resulted from medical malpractice, speak to a birth injury lawyer on our New Jersey legal team. Consult with us free of charge about your birth experience and your child’s resulting health problems. When our experienced medical malpractice attorneys believe you have a valid claim after some initial research and investigation, we can help you redress the wrongs your child suffered from medical negligence and begin to craft the case against those responsible.

Our team is skilled at preparing your case for a trial on the issues of who is liable and how a medical professional should be held accountable for your ongoing damages. We also use negotiation tactics to obtain a settlement for your child and your family. Negotiations are typically lengthy as insurance companies are not in the habit of agreeing to payouts quickly and easily. However, our attorneys always prepare your case as if it is to be decided by a jury, compiling all the evidence to prove negligence, causation, and damages. Discuss what that means with a qualified member of our legal team by contacting us at 866-708-8617 today.

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