Selective dorsal rhizotomy

This is a neurosurgical procedure in which the surgeon performs a laminectomy and ablates 70-90% of the dorsal or sensory nerve roots. This may be beneficial in both the short term and long term to treat velocity-dependent spasticity. Patients must be selected carefully for this procedure, because the weakness produced may decrease the level of functional independence. Underlying weakness is uncovered with the decrease in spasticity. Some patients also depend on some of their spasticity to stand or walk. This surgery has come to be performed less frequently since the advent of the baclofen pump. Because of the laminectomies, some of the earlier surgeries had complications of more severe lumbar lordosis several years after surgery. Most surgeons are currently doing smaller laminectomies of only 1-2 levels.