About Brody

Brody was born at 31 weeks premature and only weighing right at 3lbs.  Right after birth he suffered from respiratory distress and they sent him to nearest NICU.  He fought for over a month in the NICU.  He stayed on a ventilator and pic line till he gained some weight.  Then a Grade 2 brain bleed, PVL(severe brain damage causing white matter all over the brain. Now at 12mths he still has the PVL, spastic cerebral palsy, and is bilateraly blind. His neurologist is only giving him a 20% chance of every walking.  Brody is seeing several doctors in Atlanta, Macon, physical therapy two times a week, and will start occupation and speech soon as well.  He will have to have some surgeries coming up soon to loosin his muscle tone up.  And also a surgery called  Selective Dorsal Rhizotomy (SDR) in St. Louis.  I will give a some information on this surgery so you all can know more about this surgery.  But this is not allowed for insurance to cover so we will have to pay for this surgery out of pocket.  We want Brody to walk and be able to play with other children even though he has no vision we still want him to enjoy his life.   I think we all need to give this little boy a chance as we did.  We adopted Brody and his sister Hope at birth.  We love both of them dearly.  And want the best for both of them!  Brody has the sweetest smile and loves to cuddle and coos to everyone!  Please help our family!

Information on Selective Dorsal Rhizotomy (SDR)

Of all the surgical procedures currently performed on patients with cerebral palsy (CP),  selective dorsal rhizotomy (SDR) has undergone more thorough scientific  scrutiny than any other (including orthopedic surgery). Accumulated  evidence and our own experience indicate that SDR is an excellent option  for selected patients with spastic cerebral palsy. We believe parents and patients should inquire about SDR as a part of the management of CP before the patient undergoes orthopedic surgery.

The Selective Dorsal Rhizotomy Procedure SDR involves sectioning (cutting) of some of the sensory nerve fibers 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.

Details of our SDR Procedure Different surgical techniques are utilized to perform SDR. Neurosurgeons typically perform SDR after removing the lamina ( laminectomy ) from 5-7 vertebrae. That technique was also used at the St. Louis Children’s Hospital Cerebral Palsy Center to  perform SDR on over 140 children with CP. However, we were concerned  about possible problems that can arise from removal of such a large  amount of bone from the spine. Additionally, because of the extensive  removal of the bone, we could not offer SDR to children with weak trunk  muscles or to adults. In 1991, we developed a less  invasive surgical technique, which requires removal of the lamina from  only 1-2 vertebrae. We refined the technique further and currently  remove the lamina from a single lumbar vertebra (Figure A&B).

SDR begins with a 1- to 2-inch incision along the center of the lower back just above the waist. The spinous processes and a portion of the lamina are removed to expose the spinal cord and spinal nerves. Ultrasound and an x-ray locate the tip of the spinal cord, where there is a  natural separation between sensory and motor nerves. A rubber pad is  placed to separate the motor from the sensory nerves. The sensory nerve  roots that will be tested and cut are placed on top of the pad and the  motor nerves beneath the pad, away from the operative field.After the sensory nerves are exposed, each sensory nerve root is  divided into 3-5 rootlets. Each rootlet is tested with EMG, which  records electrical patterns in muscles. Rootlets are ranked from 1  (mild) to 4 (severe) for spasticity. The severely abnormal rootlets are  cut. This technique is repeated for rootlets between spinal nerves L2  and S2. Half of the L1 dorsal root fibers are cut without EMG testing.

When testing and cutting are complete, the dura mater is closed, and fentanyl is given to bathe the sensory nerves directly. The other layers of tissue, muscle, fascia, and subcutaneous tissue are sewn. The skin is closed with glue. There are no stitches to  be removed from the back. Surgery takes approximately 4 hours. The patient goes to the recovery room for 1-2 hours before being transferred to  the Neurology/Neurosurgery Floor.

Advantages of our SDR Technique Over Other Techniques We believe that our selective dorsal rhizotomy procedure has these significant advantages over others:

  1. Reduced risk of spinal deformities in later years
  2. Decreased post-rhizotomy motor weakness
  3. Reduced hip flexor spasticity by sectioning the first lumbar dorsal root
  4. Shorter-term, less intense back pain
  5. Earlier resumption of vigorous physical therapy