Rhizotomy Health Article

Risks

Rhizotomy carries small but significant risks of nerve damage, permanent loss of sensation or altered sensation, weakness of the lower extremities, bowel and bladder dysfunction, increased likelihood of hip dislocation, and scoliosis progression. Anesthesia carries its own risks.

Normal results

Rhizotomy reduces spasticity, which should allow more normal gait and improve mobility. Patients may require fewer walking aids, such as walkers or crutches.

Morbidity and mortality rates

Other than the risks from anesthesia, rhizotomy does not carry a risk of death during surgery. Morbidity rates vary among centers performing the surgery. Persistent and significant adverse effects may occur in 1–5% of patients, including bowel or bladder changes and low back pain.

Alternatives

Other spasticity treatments include oral medications and an implanted pump delivering baclofen to the space around the spinal cord (intrathecal baclofen). These may be appropriate alternatives for some patients. Orthopedic surgery can correct deformities that occur from untreated spasticity. Some controversy exists whether rhizotomy can delay or prevent the need for other spasticity procedures, especially orthopedic surgery such as tenotomy, with some evidence suggesting it can, and other evidence suggesting it may not.

ORGANIZATIONS

United Cerebral Palsy. 1660 L Street, NW, Suite 700, Washington, DC 20036. (800) 872-5827 or (202)776-0406. TTY: (202) 973-7197. Fax: (202) 776-0414. webmaster@ ucp.org. <http://www.UCP.org>.

WE MOVE. <http://www.wemove.org>.

Richard Robinson

WHO PERFORMS THE PROCEDURE AND WHERE IS IT PERFORMED?

Rhizotomy is performed by a neurosurgeon in a hospital. The patient's neurologist and physical therapist may also be in attendance to help with the evaluation during surgery.

QUESTIONS TO ASK THE DOCTOR

• How many rhizotomies have you performed?
• What is your complication rate?
• Is orthopedic surgery still likely to be necessary later on?