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Cerebral Palsy and Selective Dorsal Rhizotomy treatment options


    NHS England announced in July 2014 that it would now commission specialist selective dorsal rhizotomy surgery for children who suffer from cerebral palsy and have difficulties walking, where it might improve their mobility.

    By Kerstin Kubiak

I have written previously about Selective Dorsal Rhizotomy surgery (SDR), which has to date been a very contentious issue with a high number of families across the UK having to fund the surgery privately or indeed seek treatment abroad, usually by travelling to the USA. The NHS has to date significantly restricted funding for SDR surgery as it was felt the costs of the treatment outweighed the benefits gained. NHS England have now confirmed that they will fund a programme for children who qualify to undergo this surgery at one of 5 specialist centres across the UK.

What is SDR surgery and what are the benefits?

Selective Dorsal Rhizotomy surgery aims to reduce tight and stiff lower limb muscle tone in children with cerebral palsy. The surgery is expensive, costing around £50,000 for each procedure. Quite often children with cerebral palsy are unable to walk and wheelchair dependent, however with SDR surgery some children are enabled to walk independently or with the use of walking aids.  Quite often lower limb contractures are extremely painful for children and this surgery can also assist with reducing pain and spasms.

One mother, Sharon Brown, whose son Callum underwent the surgery in the USA in January 2013 told the Evening Chronicle: “I think it’s important that funding on the NHS is offered to all children who would benefit from the procedure and the criteria for those eligible should be widened.”.

She also stated: “It is tiny, little things like that, but being able to walk to the bench and make himself a drink, being able to go to the fridge and get a yoghurt himself, things every other child takes for granted mean so much to us now. …He can play football in the garden with his dad and granddad for the first time, which is all he ever wanted to do.” .

Comment from NHS England:

NHS England have agreed, under their innovative evaluation programme, to fund SDR surgery in an effort to assess it’s effectiveness in improving lives of children with cerebral palsy. Although only 5 centres in England have been approved under this scheme children can be referred to one of these specialist hospitals for surgery, if they meet the criteria.

James Palmer, Clinical Director of Specialised Services at NHS England, said: “For children with cerebral palsy, being unable to walk easily can be extremely distressing and painful. Although current evidence is limited, SDR surgery shows real promise for some patients with mobility problems and that’s why we want to explore it further through out innovative evaluation programme.”


Although the news of this funding for surgery is very warmly welcomed, it must be put in context that not all children with cerebral palsy will be given the opportunity for treatment as there are narrow inclusion criteria.

In addition it is not just the surgery which is important, but the intensive therapeutic input required afterwards from specialist physiotherapists. The treatment must been seen as the “whole package” of care including the intense post operative rehabilitation required; funding must be made available for this also.

Our experience:

As a clinical negligence solicitor I act for many young children who have cerebral palsy as a result of negligence around the time of their birth; many of their parents are keen to explore the possibility of SDR surgery.  It is pleasing that steps are being taken so more children can be considered for SDR surgery and I will be following progress of the evaluation programme with interest.

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