Samuel Browd, MD, PhD, is a neurosurgeon and surgical director of the Tone Management Program at Seattle Children’s. He is a world leader in training surgeons in selective dorsal rhizotomy (SDR) procedures. Roughly 1 in 4 surgeons in the United States who offer SDR trained under Dr. Browd, in addition to many doctors from around the world.


Q: Who is SDR for?

Dr. Browd: Any child with high tone (spasticity) in their lower extremities is a possible candidate for SDR [selective dorsal rhizotomy] surgery.  This includes many children with cerebral palsy. Providers and parents often think of surgery as a last resort, but in the case of kids with high tone, we encourage them to think of it as an early option instead. Even if their spasticity is being reasonably well-managed by medication and/or therapies, SDR can help them reduce or even get off their medication. With better physical functioning and mobility, we see kids do better with their social, family and school life too — because they’re putting less physical and mental energy into controlling their body and more time into doing things that are fun for them. Longer-term, kids are less likely to require more surgeries or experience some of the serious health consequences of having high tone.

Ages 3 to 5 is when we like to see kids get evaluated for SDR because their neuroplasticity is so high at that age, but we also consider the surgery for older children.

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