Selective dorsal rhizotomy (SDR) program

The SDR Program includes an assessment clinic, surgery and post-operative rehabilitation. 

Cerebral palsy (CP) affects 1 in 500 children in North America. One of the most common symptoms of CP is high muscle tone that causes stiffness (also known as spasticity), which can affect movement and cause pain. Selective dorsal rhizotomy (SDR) surgery can help some children with CP have reduced spasticity in their leg muscles.

The SDR Program includes an assessment clinic, surgery and post-operative rehabilitation. The SDR Program is a joint three-year collaboration between Holland Bloorview Kids Rehabilitation Hospital and The Hospital for Sick Children (SickKids), supported by the Ministry of Health and Long-Term Care.

Who is eligible for the program?

Children in Ontario with Bilateral Spastic Cerebral Palsy (Spastic Diplegic sub-type) who are between the ages of 4 years and 8 years and have goals to improve standing, walking or running may be eligible for the SDR Program. Children are individually assessed to determine the best care pathway and outcomes to meet their unique needs and goals.

The SDR Program assessment criterion is based on the best available evidence and was informed by experts from across Ontario.

How can my child get a referral to the program?

Families should contact their local children’s treatment centre (CTC) to request an initial assessment with their treatment centre affiliated physician. The CTC affiliated physician will do an assessment and if appropriate make a referral to the SDR Program assessment clinic. The SDR Program assessment clinic will determine eligibility for SDR surgery.

What can families expect in the program?

The SDR Program consists of a multidisciplinary team that includes a neurosurgeon, pediatric rehabilitation specialist, physiotherapist (PT), orthopedic surgeon and registered nurse.

Children who are referred to the SDR Program assessment clinic by their local children’s treatment centre (CTC) may expect the following:
 

  1. An in-depth assessment at the SDR Program assessment clinic at Holland Bloorview in Toronto to determine if a child is eligible for SDR surgery.

  2. If a child is determined to be eligible for SDR surgery following the in-depth assessment at Holland Bloorview and the child and family decide to proceed, the child will receive surgery at SickKids and will stay at SickKids as an inpatient for approximately four or five days.

  3. The child will then be transferred to Holland Bloorview for up to three months of intensive inpatient and/or day-patient rehabilitation.

  4. After discharge from Holland Bloorview, the child will then receive physiotherapy at their local children’s treatment centre (CTC) for up to 12 months post-surgery. During this time period, the child will also have two follow up assessments at Holland Bloorview in Toronto.