Talk:Selective dorsal rhizotomy

Wiki Education Foundation-supported course assignment
This article is or was the subject of a Wiki Education Foundation-supported course assignment. Further details are available on the course page. Student editor(s): Halestorm18, AlexLamphear, Hoodryan24. Peer reviewers: GR3GP1K3, Kolby Arnold, Wacomer, Rsnorton3, Hpeabody, SBerenyi4, Codystgermain, McGinnisb.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 08:08, 17 January 2022 (UTC)

note
"However, recent cases of successful SDR procedures among those with spastic diplegia across all major age ranges (years 3-40) has finally proven its universal effectiveness and safety regardless of the age of the spastic diplegic patient."

No citation for this, and "universal effectiveness and safety" seems strong.

"In general, there is a combined 5-10% risk of any of the following more serious risks happening as a result of SDR. Because of technological advances in both the technology used in the surgery and also in the procedure itself, there have been no major cases of SDR that have had these side-effects."

Again, the second sentence seems tacked on and doesn't seem right - how would they know there were these side-effects if no cases have had them?

I think the whole article needs looking at - seems quite biased towards the surgery.

Response to the above user
(1) There have been recent cases that have proven its universal effectiveness across both older and younger people. I'm one of those examples and I know several people older than me. We physically prove it, and my upcoming documentary will show that (in the meantime you're free to look at the cases that are publicly available on the internet). (2) The reason it is known that there are side-effects of these types is because a few people historically have had them, but it's not possible via simple internet searches to find out who the people are who have had them. The article does not say that no cases of SDR have had these side effects; it says that no major (i.e. no visibly, widely known) cases have had these side effects. Therefore, it is perfectly reasonable to list the side effects, just as it is equally important to list what neurosurgeons who do this surgery say is the percentage of likelihood of the side-effects occurring. I have heard some neurosurgeons say 5% and some neurosurgeons say closer to and including 10%, so the only solution is to publish a 'range' rather than a specific percentage. (3) The article only seems biased towards the surgery because the positive aspects consistently and tangibly outweigh any negative ones. Unless the surgery is done wrong, by people who don't know what they're doing, which is a separate matter than the surgery itself (any surgery can be done wrong, and this doesn't mean the surgery itself then suffers reputational damage), the surgery is basically universally positive. If you seek to balance the article by adding negative information, please be sure you have citations for those negative aspects, because personally, the only examples of rhizotomy turning out negatively that I have either talked to people about or have been able to research academically, have come as a result of a surgeon being clueless and/or shoddy. Kikodawgzzz (talk) 08:15, 20 May 2011 (UTC)

The first aspect of the article I would like to fix is the grammatical errors throughout the entire article. As the article suggests I would also like to add in additional citations for verification, so the reader knows where particular information was originally published. The article has a lot of good information, it just needs extra citations to help support the information. I would also like to see connecting sentences from one paragraph to another, many paragraphs randomly start discussing a new topic without concluding the last paragraph. I would also like to improve the sections about Long-Term Effects and strengthening after the procedure because in a quick search in a database I have found tons of articles explaining follow up studies several years after the procedure. I also found articles about physical therapy involvement after the procedure and how therapy sessions benefit the child. I believe these two areas are lacking the most information in the article itself. Following are citations of articles I would like to pull information from to help improve this article. A 30-year follow-up study after selective dorsal rhizotomy: neuromuscular and functional status of adults with cerebral palsy and bilateral lower limb spasticity. (2017). Developmental Medicine & Child Neurology, 5971-72. doi:10.1111/dmcn.110_13511

Al-Shaar, H. A., Imtiaz, M. T., Alhalabi, H., Alsubaie, S. M., & Sabbagh, A. J. (2017). Selective dorsal rhizotomy: A multidisciplinary approach to treating spastic diplegia. Asian Journal Of Neurosurgery, 12(3), 454-465. doi:10.4103/1793-5482.175625

Bolster, E. M., van Schie, P. M., Becher, J. G., van Ouwerkerk, W. R., Strijers, R. M., & Vermeulen, R. J. (2013). Long-term effect of selective dorsal rhizotomy on gross motor function in ambulant children with spastic bilateral cerebral palsy, compared with reference centiles. Developmental Medicine & Child Neurology, 55(7), 610-616. doi:10.1111/dmcn.12148

Daunter, A. K., Kratz, A. L., & Hurvitz, E. A. (2017). Long-term impact of childhood selective dorsal rhizotomy on pain, fatigue, and function: a case-control study. Developmental Medicine And Child Neurology, 59(10), 1089-1095. doi:10.1111/dmcn.13481

FRIGON, C., LOETWIRIYAKUL, W., RANGER, M., & OTIS, A. (2009). An acute pain service improves postoperative pain management for children undergoing selective dorsal rhizotomy. Pediatric Anesthesia, 19(12), 1213-1219. doi:10.1111/j.1460-9592.2009.03184.x

Grunt, S., Becher, J., & Vermeulen, R. (2011). Long-term outcome and adverse effects of selective dorsal rhizotomy in children with cerebral palsy: a systematic review. Developmental Medicine & Child Neurology, 53(6), 490-498. doi:10.1111/j.1469-8749.2011.03912.x

Josenby, A., Wagner, P., Jarnlo, G., Westbom, L., & Nordmark, E. (2012). Motor function after selective dorsal rhizotomy: a 10-year practice-based follow-up study. Developmental Medicine & Child Neurology, 54(5), 429-435. doi:10.1111/j.1469-8749.2012.04258.x

Macwilliams, B., Johnson, B., Shuckra, A., & D'Astous, J. (2011). Functional decline in children undergoing selective dorsal rhizotomy after age 10. Developmental Medicine & Child Neurology, 53(8), 717-723. doi:10.1111/j.1469-8749.2011.04010.x

McLaughlin, J. (2012). Motor function after dorsal rhizotomy. Developmental Medicine And Child Neurology, 54(5), 389-390. doi:10.1111/j.1469-8749.2012.04255.x

Rumberg, F., Bakir, M. S., Taylor, W. R., Haberl, H., Sarpong, A., Sharankou, I., & ... Funk, J. F. (2016). The Effects of Selective Dorsal Rhizotomy on Balance and Symmetry of Gait in Children with Cerebral Palsy. Plos ONE, 11(4), 1-11. doi:10.1371/journal.pone.0152930

Steinbok P. Outcomes after selective dorsal rhizotomy. Developmental Medicine And Child Neurology [serial online]. March 2015;57(3):214-215. Available from: MEDLINE, Ipswich, MA. Accessed September 27, 2017.

Tedroff, K., Löwing, K., & Åström, E. (2015). A prospective cohort study investigating gross motor function, pain, and health-related quality of life 17 years after selective dorsal rhizotomy in cerebral palsy. Developmental Medicine & Child Neurology, 57(5), 484-490. doi:10.1111/dmcn.12665

Trost, J. P., Schwartz, M. H., Krach, L. E., Dunn, M. E., & Novacheck, T. F. (2008). Comprehensive short-term outcome assessment of selective dorsal rhizotomy. Developmental Medicine And Child Neurology, 50(10), 765-771. doi:10.1111/j.1469-8749.2008.03031.x

Vermeulen, R. J., & Becher, J. G. (2015). Long-term outcome in selective dorsal rhizotomy in spastic cerebral palsy: differentiation in mobility levels is needed. Developmental Medicine And Child Neurology, 57(5), 408-409. doi:10.1111/dmcn.12695

What do we know about physical therapy post selective dorsal rhizotomy?. (2017). Developmental Medicine & Child Neurology, 5919. doi:10.1111/dmcn.24_13511 Halestorm18 (talk) 20:33, 27 September 2017 (UTC) Halestorm18

I think some information about what age ranges benefit the most from the surgical intervention should be reinforced in the article, as of which I have stated below. I also believe that information regarding long term benefits of the surgical intervention should be added to make people aware of the functional potential these children may achieve as they enter adulthood, which I have also listed below.

"SDR yields durable reduction in spasticity after 10 years. Early improvements in motor function are present, but at long-term follow-up, these improvements were attenuated in GMFCS II and III and were not sustained in GMFCS IV and V."

Ailon, T., Beauchamp, R., Miller, S., Mortenson, P., Kerr, J., Hengel, A., & Steinbok, P. (2015). Long-term outcome after selective dorsal rhizotomy in children with spastic cerebral palsy. Child's Nervous System, 31(3), 415-423. doi:10.1007/s00381-015-2614-9

"DR are between 4 and 7 years old and have a preoperative GMFM between 65% and 85%."

Funk, J. F., Panthen, A., Bakir, M. S., Gruschke, F., Sarpong, A., Wagner, C., & ... Haberl, E. J. (2015). Predictors for the benefit of selective dorsal rhizotomy. Research In Developmental Disabilities, 37127-134. doi:10.1016/j.ridd.2014.11.012

"Two of the classic studies of the efficacy of SDR5,6 were limited to children below 7 years old and showed improvement in gross motor function whereas a third study7 which extended to 18 years showed only mar- ginal improvement. The current study by MacWilliams et al. would appear to confirm that SDR is generally in- appropriate in later childhood and adolescence when other factors are more important than spasticity."

Baker, R., & Graham, K. (2011). Functional decline in children undergoing selective dorsal rhizotomy after age 10. Developmental Medicine & Child Neurology, 53(8), 677. doi:10.1111/j.1469-8749.2011.04020.x

Additional ideas for the article
I'd like to make several different edits to this page including grammar, addition of reliable sources, expansion of certain sections (including complications, intro, and background), and adding some pictures to make the page more appealing to the eye. I would also like to look into more functional outcomes and perhaps clinical presentations of patients with spasticity prior to the selective dorsal Rhizotomy surgery. I have listed a few different sources that I think will help- I will continue to add to the repertoire of sources as time goes on.

Farmer, J., & Sabbagh, A. J. (2007). Selective dorsal rhizotomies in the treatment of spasticity related to cerebral palsy. Child's Nervous System, 23(9), 991-1002. doi:10.1007/s00381-007-0398-2

Golan, Jeff & Hall, Jeffery & O'Gorman, Gus & Poulin, Chantal & Ezer Benaroch, Thierry & Cantin, Marie-Andree & Farmer, Jean-Pierre. (2007). Spinal deformities following selective dorsal rhizotomy. Journal of neurosurgery. 106. 441-9. 10.3171/ped.2007.106.6.441.

Cahill-Rowley, K., & Rose, J. (2014). Etiology of impaired selective motor control: emerging evidence and its implications for research and treatment in cerebral palsy. Developmental Medicine & Child Neurology, 56(6), 522-528. doi:10.1111/dmcn.12355

Bolster, E. A., Schie, P. E., Becher, J. G., Ouwerkerk, W. J., Strijers, R. L., & Vermeulen, R. J. (2013). Long-term effect of selective dorsal rhizotomy on gross motor function in ambulant children with spastic bilateral cerebral palsy, compared with reference centiles. Developmental Medicine & Child Neurology, 55(7), 610-616. doi:10.1111/dmcn.12148 AlexLamphear (talk) 20:13, 9 October 2017 (UTC)AlexLamphear

A Few Points
Overall this article has a good start. I would suggest going through the article and try to find all of the places where references could be made. There are some claims made throughout the article that are not shown to be backed up by the literature. For example: in the first paragraph, there is a reference that SDR is the most common rhizotomy procedure performed. I believe this should have a reference to show that it is factual. The rest of the paragraph after that could probably use a reference too. This is just one example but I found many throughout. I would also suggest either making separate pages for the different types of rhizotomies, or more simply, just have a section that goes over what the different types are and how they differ.Codystgermain (talk) 19:01, 14 October 2017 (UTC)

I wrote an edit that included a few different types of the rhizotomies in my sandbox, so I completely agree with you there! I didn’t know exactly where to place the section, but I do not believe it should be in the introduction as it is currently. Hoodryan24 (talk) 20:10, 16 October 2017 (UTC)

The article looks well put together with small bias. I have made a few grammar edits here and there to increase clarification. If you keep adding more references to several points throughout the page, it will come together nicely. GR3GP1K3 (talk) 01:57, 18 October 2017 (UTC)

A couple questions about research
Hi! The article is looking good I just have a few questions. Did you find any new information on long term effects of SDR or do you know if it is being further researched? I was also looking at the background information and noticed there weren't any citations. Did you find some research to back up that information? Hpeabody (talk) 01:47, 22 October 2017 (UTC)

Hello! When I first looked at the article, I noticed the lack of information describing the long term effects of SDR and I did some research. I was able to find peer reviewed articles with this information. I will be incorporating that information in that section to help readers understand there is now research available about the long term effects. Halestorm18 (talk) 10:00, 23 October 2017 (UTC)Halestorm18

Where is SDR available
Could have a new section summarising where SDR is available. I don't have sources but from newspapers I gather it has limited and growing availability in the UK since 2010 - eg at Leicester childrens hospital (Dr J Goodden has done at least 93 SDRs). What's the situation in say Canada, France, Germany etc and various states of the USA ? - Rod57 (talk) 08:15, 28 July 2018 (UTC)

Longterm effects
Good article so far. A section that would be useful would be to mention long term effects post surgery such as arthritis, returning spasticity, or whether there are tweaking surgeries down the road for these patients — Preceding unsigned comment added by 144.13.129.14 (talk) 14:53, 12 October 2018 (UTC)

Requested move 9 May 2024

 * The following is a closed discussion of a requested move. Please do not modify it. Subsequent comments should be made in a new section on the talk page. Editors desiring to contest the closing decision should consider a move review after discussing it on the closer's talk page. No further edits should be made to this discussion.

The result of the move request was: moved. Moved without consensus, as an uncontested technical request. Any objection within a reasonable time frame should result in the move being reverted and the request being reopened. (closed by non-admin page mover) BilledMammal (talk) 23:59, 16 May 2024 (UTC)

Rhizotomy → Selective Dorsal Rhizotomy – I read this entire article and barely caught the Note at the bottom letting me know it was not in fact about the topic I had come for. The note gives a clear, unambiguous term "Selective Dorsal Rhizotomy", which seems like it would be a good new name for the article. At the very least, if the move is contested, the note should be converted back to a Hatnote so others don't wind up in my situation. The John Hopkins page on Rhizotomy (archive) seems to cover all of the procedures, not just this one for spasticity. Cleveland Clinic refers to Rhizotomy as an "umbrella term". rubah (talk) 02:03, 9 May 2024 (UTC) "This article deals with Selective Dorsal Rhizotomy (SDR) rather than the rhizotomy procedures for pain relief; for those procedures, which have begun to take the name "rhizotomy" in certain instances, see facet rhizotomy and similar. A facet rhizotomy is just one of many different forms of radiofrequency ablation, and its use of the "rhizotomy" name should not be confused with the SDR procedure." Note text copied here for quick reference. rubah (talk) 02:03, 9 May 2024 (UTC) The discussion above is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.
 * Comment. If moved it should be to Selective dorsal rhizotomy. -- Necrothesp (talk) 13:37, 14 May 2024 (UTC)