Rhizotomy: This four-year-old boy has spastic diplegic cerebral palsy secondary to prematurity. He has had multiple botulinum toxin injections at 6-month intervals from the age of 18 months. The patient responded well to the botulinum toxin, but over time the therapy began to have less effect. He was then felt to be an appropriate candidate for selective dorsal rhizotomy and underwent the procedure. One year following the rhizotomy the patient had significant improvement in his ambulation with more efficient gait patterns.

His parents commented that it was easier for him to run and to walk up and down steps. His overall endurance for communal activities was much improved, and he was able to play with peers more easily. He was felt to be a candidate for orthopedic procedures prior to the rhizotomy, but one year post-rhizotomy, his contractures were not severe enough to warrant more aggressive interventions.

He has not required additional surgeries for the three years following his rhizotomy. This child, however, may have gastocnemius recession, particularly on the left side, as he gets closer to his adolescent growth spurt. The patient will continue to be followed periodically, and a decision regarding further surgery will be when he is older.