Rhizotomy is a neurosurgical procedure that is performed on the spinal cord of patients with spastic cerebral palsy, an abnormality in the motor tone and function present at birth which causes a rigid posture. Based on a study published by the "Hong Kong Medical Journal" in September 1999, two groups of cerebral palsy patients can benefit from rhizotomy: severely affected spastic quadriplegics, patients with all limbs affected with spasticity and spastic patients with some ambulatory skills who are disabled due to spasticity.
Sensory Change
Sensory changes can happen in 3.8 percent of cases, according to a study published in June 1998 by "Pediatric Neurosurgery." This is most probably due to the many cuts done to the dorsal nerve tissue, the part of the spinal cord that conveys sensation. This problem is one of the biggest post-operative concerns in the physical therapy of pediatric patients who undergo rhizotomy, according to a study published by the "Journal of Pediatric Psychology" in April 1997. One of the best ways to avoid this complication is by sparing at least one fifth of the affected nerve roots during the surgery.
Neurogenic Bladder
Neurogenic bladder is a urinary problem, which may be the inability to control urination or the inability to completely empty the bladder during urination, that results from interference of the nerve communication in the spinal cord associated with urination. This can happen in 1.3 percent of cases, according to the aforementioned study in "Pediatric Neurosurgery." Cutting of less than 50 percent of certain spinal nerve roots during the operation can lower the incidence of long-term bladder dysfunction.
Progressive Spinal Deformity and Hip Subluxation
Progressive spinal deformity and hip subluxation, or partial dislocation, are usually observed in children undergoing a type of rhizotomy called dorsal selective rhizotomy, according to the book, "Spine surgery: techniques, complication, avoidance, and management." However, the exact mechanism of how this problem happens is unknown.
Muscle Atrophy
Muscle atrophy, or muscle wasting, usually follows the resection of some the ventral nerve roots, the part of the spinal cord that is responsible for muscle movement control. In a paraplegic -- a patient with complete paralysis of the lower extremities -- the atrophy of the buttock and the thigh muscles may result in a much lower quality of life and other consequences, according to "Spine surgery: techniques, complication, avoidance, and management."
References
- "Archives of Disease in Childhood"; Trends in birth prevalence of cerebral palsy; Pharaoh, P.O., et al.; April 1987
- "Pediatric Neurosurgery"; Complications after selective posterior rhizotomy for spasticity in children with cerebral palsy; Steinbok, P, et al.; June 1998
- "Hong Kong Medical Journal"; Selective posterior rhizotomy: results of five pilot cases; Yam, K.Y.; September 1999
- "Journal of Pediatric Psychology"; Pain, Anxiety, and Cooperativeness in Children with Cerebral Palsy After Rhizotomy: Changes Throughout Rehabilitation; Cate Miller, A., et al.; April 1997
- "Spine Surgery: Techniques, Complication, Avoidance, and Management"; Edward Benzel; 2005
