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Selective dorsal rhizotomy (SDR)
- Paediatric neurosurgical care in a specialist children's hospital
- Permanent reduction in leg spasticity with structured rehabilitation
- Improved quality of life for children with spastic diplegic cerebral palsy
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Selective dorsal rhizotomy at HCA UK
Why choose us?
At The Portland Hospital, selective dorsal rhizotomy (SDR) is performed by expert paediatric neurosurgeons with the support of a dedicated multidisciplinary team. From the first assessment through to surgery and long-term rehabilitation, your child's care is tailored to their needs.
Selective dorsal rhizotomy can help improve mobility, ease muscle stiffness and support your child's independence. After surgery, your child will have a short stay in hospital to receive focused post-operative care from our specialist team. Your child will also complete several weeks of on-site physiotherapy to aid their recovery.
Selective dorsal rhizotomy can help improve mobility, ease muscle stiffness and support your child's independence. After surgery, your child will have a short stay in hospital to receive focused post-operative care from our specialist team. Your child will also complete several weeks of on-site physiotherapy to aid their recovery.
Selective dorsal rhizotomy or SDR is a type of neurosurgery that helps reduce muscle stiffness, known as spasticity. By carefully cutting certain sensory nerve rootlets in the spine, SDR helps improve control and comfort, making it easier for your child to move and enjoy more freedom in their daily life.
Your child's specialist may recommend it if they have spastic diplegic cerebral palsy and find walking stiff or tiring.
Your child's specialist may recommend it if they have spastic diplegic cerebral palsy and find walking stiff or tiring.
Your child will have a general anaesthetic so they're fully asleep throughout the surgery. Their neurosurgeon makes a small cut in the lower back to reach the spinal cord and gently separates the sensory nerves.
Each one is tested, and the nerve fibres causing stiffness are precisely cut. This reduces overactive muscle signals while protecting normal movement and sensation, helping your child move more freely over time.
Each one is tested, and the nerve fibres causing stiffness are precisely cut. This reduces overactive muscle signals while protecting normal movement and sensation, helping your child move more freely over time.
Your child will be cared for at The Portland Hospital after the operation, where our specialist team will monitor them closely and keep them comfortable. After the procedure, we will care for your child in hospital for about six days. During this time, they'll have personalised physiotherapy twice a day.
Once your child is discharged, they will need to continue to attend regular outpatient physiotherapy appointments at The Portland Hospital for a further two weeks. This period of rehabilitation is essential in optimising the outcome of the surgery.
Following this, your child will require ongoing regular physiotherapy input for the next six months. We can support you in sourcing physiotherapy closer to home, or it can be provided at The Portland Hospital. We will review your child's progress at 6, 12 and 24 months after the operation.
Once your child is discharged, they will need to continue to attend regular outpatient physiotherapy appointments at The Portland Hospital for a further two weeks. This period of rehabilitation is essential in optimising the outcome of the surgery.
Following this, your child will require ongoing regular physiotherapy input for the next six months. We can support you in sourcing physiotherapy closer to home, or it can be provided at The Portland Hospital. We will review your child's progress at 6, 12 and 24 months after the operation.
Recovery after SDR is a gradual process that takes time, patience and teamwork between your family and your child's therapists. You'll be supported every step of the way with a clear plan for progress.
Here's what to expect:
Here's what to expect:
- In hospital: Physiotherapy begins soon after surgery to start building strength and confidence.
- After discharge: Physiotherapy continues for at least two weeks.
- Ongoing rehab: Several sessions a week for at least six months, and often up to two years.
- Regular reviews: Your child's specialist will check progress and adjust therapy as they grow stronger.
Each child reacts to SDR in a unique way. Many families notice meaningful improvements in their child's movement and comfort following SDR.
The procedure aims to ease muscle stiffness and make everyday activities feel easier and more natural. Your child's specialist will discuss what's realistic for them based on their needs and abilities.
Benefits:
The procedure aims to ease muscle stiffness and make everyday activities feel easier and more natural. Your child's specialist will discuss what's realistic for them based on their needs and abilities.
Benefits:
- Reduces muscle stiffness and improves mobility.
- Helps with smoother walking and better sitting balance.
- Supports greater independence in daily activities.
- Temporary weakness or changes in sensation.
- Possible spinal curvature, bladder issues, CSF leak or infection.
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With results in as little as 48 hours
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Our complete breadth of expertise focused on your child
Your child’s selective dorsal rhizotomy with HCA UK
What to expect
When you choose private selective dorsal rhizotomy at The Portland Hospital, you can have peace of mind that you and your child are in safe hands. Our experienced team will guide you throughout the journey, ensuring every stage is thoughtfully planned to provide the best possible experience and lasting results.
01
Initial consultation
Your child's journey begins with a referral from their GP or paediatrician. Our multidisciplinary team, including neurosurgeons, physiotherapists and neurologists, will carry out a full assessment. We'll review your child's condition, answer any questions and ensure SDR is the right treatment for their individual needs.
02
Diagnostic evaluation and candidacy determination
Your child's team will complete a detailed diagnostic assessment, which may include MRI scans, muscle strength testing and gait analysis in a specialist lab. Physiotherapy evaluations help confirm that your child has enough motor control to benefit from SDR. This step ensures the surgery is suitable and likely to achieve the best long-term results.
03
Pre-assessment of walking ability
Before surgery, your child's team will carry out a full pre-assessment of walking ability, muscle strength and mobility. You'll also have the chance to talk about the procedure, understand any potential risks and set clear goals together.
04
The SDR surgery day
On the day of surgery, your child will have a general anaesthetic. The neurosurgeon identifies and tests the sensory nerve rootlets before carefully cutting the ones responsible for muscle stiffness. The incision is closed with dissolvable stitches, and your child's hospital stay begins with attentive, specialist care to support their initial recovery.
05
Post-operative follow-up care
After discharge, outpatient therapy continues for several weeks, helping your child build strength and confidence. Progress is reviewed at approximately 6, 12 and 24 months. Your child's team will guide and support you at every stage to ensure lasting improvement and independence.
Our location
Where can my child have selective dorsal rhizotomy?
Your child can have selective dorsal rhizotomy at The Portland Hospital. Our expert teams combine medical excellence with a warm, supportive approach that helps families feel reassured from the very start.
With a welcoming, child-friendly environment and specialist rehabilitation support, we ensure your child's safety, comfort and confidence every step of the way.
With a welcoming, child-friendly environment and specialist rehabilitation support, we ensure your child's safety, comfort and confidence every step of the way.
The Portland Hospital
205-209 Great Portland Street W1W 5AH London
Accessing private healthcare
Self-pay
You don’t need health insurance for your child to be seen quickly. If you’re looking for a diagnosis or treatment and don’t want to wait, all of our private healthcare services – from private GP appointments through to surgery and aftercare – can be paid for as and when you need them.
And we’ll give you a clear and transparent quote from the start, outlining exactly what’s included in your self-pay package.
Selective dorsal rhizotomy FAQs
Selective dorsal rhizotomy is performed under general anaesthetic. The neurosurgeon makes a small incision in the lower back to reach the spinal cord, then carefully identifies and tests the sensory nerves.
Only those that cause stiffness are cut to help relax the muscles. SDR is a permanent procedure and can't be reversed, which is why every child's suitability is carefully assessed.
Only those that cause stiffness are cut to help relax the muscles. SDR is a permanent procedure and can't be reversed, which is why every child's suitability is carefully assessed.
Children with spastic diplegic cerebral palsy usually benefit the most from SDR. It's particularly helpful for children who have good muscle strength and control but experience stiffness that makes walking or balance difficult.
SDR is typically considered for children aged between four and ten. At this age, most children are strong enough to take part in physiotherapy and still young enough to gain long-term benefit from improved mobility.
Your child's specialist will look at their strength, development and goals before deciding the best time for surgery.
Your child's specialist will look at their strength, development and goals before deciding the best time for surgery.
SDR can bring lasting improvements in mobility, comfort and independence. Many children experience smoother walking, better balance and less pain from muscle stiffness.
Like all surgeries, there are some risks, including temporary weakness, changes in sensation, bladder issues, spinal curvature or infection. Your child's specialist will discuss these carefully and help you make an informed decision.
Like all surgeries, there are some risks, including temporary weakness, changes in sensation, bladder issues, spinal curvature or infection. Your child's specialist will discuss these carefully and help you make an informed decision.
Every child's progress is different, but most experience smoother movement, better posture and more control. Many parents notice that everyday tasks, like standing or walking, become easier.
Physiotherapy plays a key role in helping your child build strength, coordination and independence, with gradual improvements continuing over months and years.
Physiotherapy plays a key role in helping your child build strength, coordination and independence, with gradual improvements continuing over months and years.
Recovery is a gradual process. Physiotherapy begins in hospital and continues in sessions several times a week for six months or longer, often up to two years. Regular reviews with your child's specialist track progress and adjust therapy as they grow stronger.
The effects of SDR are long-term. Once the overactive nerves are cut, they don't grow back, so the reduction in stiffness is permanent. With consistent physiotherapy and support, your child should continue improving in strength, coordination and independence for many years after surgery.
Yes, there are several non-surgical options to help manage spasticity. These can include physiotherapy, oral medication, Botox injections and intrathecal baclofen pumps.
Your child's specialist will explain each option and help you understand whether SDR or another treatment is likely to provide the best long-term outcome for your child.
Your child's specialist will explain each option and help you understand whether SDR or another treatment is likely to provide the best long-term outcome for your child.
The cost of private SDR depends on your child's needs, hospital stay and rehabilitation plan. Your specialist will provide a detailed estimate before treatment, so you know exactly what to expect.
You can learn more about self-pay and private treatment costs here. If you'd like to discuss payment, please call us on 020 3993 2726. Our team will be happy to help.
You can learn more about self-pay and private treatment costs here. If you'd like to discuss payment, please call us on 020 3993 2726. Our team will be happy to help.
Our patient stories
Finley's SDR story
After undergoing numerous tests during the first period of his life, Finley was diagnosed with cerebral palsy at 18 months old.
Jude's SDR surgery
Eight-year-old football fan Jude isn't letting cerebral palsy slow him down, thanks to a specialised procedure at The Portland Hospital.
Lenny's SDR surgery
Lenny was 13 months old when he was diagnosed with cerebral palsy. Thanks to specialised surgery at The Portland, his walking is rapidly improving.
“My son was looked after extremely well by the paediatric team. From arrival to pre- and post-operative care, the team were brilliant. They really put my son at ease, which in turn made me feel comfortable and confident about his treatment.”
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This content is intended for general information only and does not replace the need for personal advice from a qualified health professional.