In September of 2009 we became aware of an operation that may relieve Keira’s symptoms to the point that independent walking would be possible and better control of her muscles and limbs could be achieved.
The operation is called Selective Dorsal Rhizotomy (SDR) and is carried out in the US. A form of this operation is carried out in the UK at Oswestry Orthopaedic Hospital but the criteria for this is very strict, one of the criteria being that the child can walk independently already.
We have investigated this operation fully as it is a major spinal operation and not a route we are prepared to take lightly.
SDR involves sectioning (cutting) of some of the sensory nerve fibres that come from the muscles and enter the spinal cord. Two groups of nerve roots leave the spinal cord and lie in the spinal canal. The ventral spinal roots send information to the muscle; the dorsal spinal roots transmit sensation from the muscle to the spinal cord.
At the time of the operation, the neurosurgeon divides each of the dorsal roots into 3-5 rootlets and stimulates each rootlet electrically. By examining electromyographic (EMG) responses from muscles in the lower extremities, the surgical team identifies the rootlets that cause spasticity. The abnormal rootlets are selectively cut, leaving the normal rootlets intact. This reduces messages from the muscle, resulting in a better balance of activities of nerve cells in the spinal cord, and thus reduces spasticity.
The operation costs between $44,000 and $51,800 and requires outpatient treatment at the facility in St. Louis for up to 5 weeks post op. We have estimated that we will need to raise between £40,000 and £45,000 to fund this treatment including flights accommodation and any further incidental expenses.