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Spinal cord monitoring during selective dorsal rhizotomy

Your child has been referred for spinal surgery. This resource will give you some information about the monitoring your child’s surgeon has asked us to perform. The surgeon will have already discussed the risks of surgery with you.

What is selective dorsal rhizotomy?

Selective dorsal rhizotomy (SDR) is a specialist neurosurgical operation used to reduce stiffness in muscles (spasticity). This stiffness is caused by abnormal communication between the brain and the nerves. This surgery aims to reduce this stiffness by cutting some nerve rootlets which are not behaving normally. These nerve rootlets are found in the spinal cord, and monitoring the cord helps the surgeon to identify these rootlets.

On the day of your child’s operation

On the day of the surgery your child will be taken to theatre and into the anaesthetic room. Once they are asleep we will position very fine needle electrodes into their arms and legs. Additional needle electrodes are inserted near the opening of the bottom (rectum) to monitor bowel function. Special tape keeps the needles in place and all needles are for single use and disposed of after every surgery.

During surgery

The surgeon needs to divide the nerves within the spinal cord into 2 groups:

  • Sensory nerves – these control the feeling and sensations in the legs.
  • Motor nerves – these control the movements of muscles in the legs.

The surgeon protects the motor nerves which will not be cut. A special probe is used to send messages through the sensory nerves and record responses from the arms and legs. This information helps the surgeon to leave the nerves that are normal and to pick out the nerves that are behaving abnormally and need to be cut to improve your child’s symptoms.

After the operation

All the electrodes will be removed before your child wakes up.

Are there any additional risks in having monitoring during surgery?

Some minor bruising may occur at the needle sites where the electrodes have been inserted.


As with any procedure we must obtain your consent beforehand. Your child’s surgeon will explain all the risks, benefits and alternatives of the surgery before they ask for your consent. If you are unsure about any aspect of this procedure, please do not hesitate to ask for more information.

Find out more

If you have any questions or worries after reading this information please ring the Department of Clinical Neurophysiology on:
0114 271 3237, open Monday to Friday from 8.30am to 4.30pm.

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Disclaimer

Please note: this is a generic information sheet relating to care at Sheffield Children’s NHS FT. These details may not reflect treatment at other hospitals. This information is not intended as a substitute for professional medical care. Always follow your healthcare professionals’ instructions. If this resource relates to medicines, please read it alongside the medicine manufacturer’s patient information leaflet. If this information has been translated into another language from English, efforts have been made to maintain accuracy, but there may still be some translation errors. If you are unsure about any of the guidance in this resource or have specific questions about how it relates to your child, always ask your healthcare professional for further advice.

Resource number: NPS12

Resource Type: Article

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S10 2TH

United Kingdom

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