Efficacy of selective dorsal rhizotomy in the treatment of spasticity in children with cerebral palsy: a systematic review and meta-analysis

OBJECTIVE Spasticity is one of the most prevalent neurological disorders, affecting > 90% of patients with cerebral palsy (CP). Selective dorsal rhizotomy (SDR) is a permanent neurosurgical procedure indicated for the treatment of spasticity. This study aimed to analyze the efficacy of SDR in managing spasticity in children with CP and as well as the efficacy of this therapy over time after the intervention using different scales. METHODS A comprehensive systematic search was conducted across several databases, spanning from inception to November 5, 2023. Random-effects meta-analyses were used to calculate pooled mean differences and their corresponding confidence intervals to assess the efficacy of SDR using different scales. RESULTS All the included studies involved before-after single-arm studies, with the exception of four randomized clinical trials and one quasi-experimental study. The effect of SDR on spasticity, measured with the modified Ashworth scale (MAS) and the Gross Motor Function Measure (GMFM), was significantly improved in children with lower limb spasticity. The efficacy of the treatment was significant up to 12 months posttreatment. CONCLUSIONS SDR has been demonstrated to be effective in treating children with CP. This efficacy is evidenced by notable improvements, as measured by both the MAS and GMFM. These improvements suggested enhanced mobility and overall quality of life.