What does SDR achieve? At this time, SDR is only performed on patients with spastic deplegia cerebral palsy. It is a procedure used for the reduction of spasticity of lower extremities. Let's review spasticity for a moment. Spasticity of the muscles refers to increased tension in muscles. The signal to tense a muscle comes from the muscle and goes to the spinal cord via nerves from the muscle. While the signal for flexibility or reduced tone of muscle comes from the brain via nerves. Normally, these signals work together. A person with CP has damage to the part of brain that controlls muscle tone. This results in the interference of the correct messages sent to the spinal cord. It causes an unbalanced signal and the effect is spasticity. Some negative effects of spasticity include, inhibition of movement, muscle growth, limited stretching of muscles and development of muscle and joint deformities. The condition of CP varies in different moderations (mild to severe)of each patient.
How is this procedure performed? Briefly, how SDR works is, each dorsal sensory nerve ending coming from the muscles entering the spinal cord is electrically stimulated (EMG - electomyographic). This allows for identification of nerve endings causing the spasticity in the lower extremities. Given the stimulation, each sensory nerve ending is tested on a range of mild to severe spasticity. Selectively, the severely abnormal sensory nerve endings are cut. All normal nerve endings are left intact. Leaving a better balance of nerve endings. This surgery takes approximately four hours. A common effect after surgery is sensitivity of the skin on the feet and legs. Also change in bladder control. Both, usually resolve within a few weeks. Now that spasticity has been reduced, increasing the strength of muscles with therapy is much easier. Improvements in motor function and balance begin to take on a noticeable difference. Cognitive, Speech and emotional improvements have also been attained after SDR. Also found, after SDR, is a decrease in common deformities of CP such as, hip subluxation, foot deformities and in-toeing.
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