Selective rhizotomy for cerebral palsy: surgical treatment of spasticity
We help parents arrange selective rhizotomy for cerebral palsy by choosing a clinic and a pediatric neurosurgeon in Turkey or Israel. First the doctor reviews your child's documents and videos of how they move, then you compare clinic programs.
12,000+ patients since 2016
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About us
Experts Medical is an international medical service for treatment and surgery abroad. Your personal doctor-coordinator helps you choose a doctor for the best possible outcome, arranges your medical trip and supports you before, during and after treatment. Since 2016 we have helped 12,000+ patients, and we represent 300+ leading clinics worldwide.
Rhizotomy and other treatments for spasticity in cerebral palsy
Selective rhizotomy reduces excessive muscle tone in the legs, but it is not suitable for every child: the form of cerebral palsy, age, muscle strength and the skills the child already has all matter. The decision is made by a pediatric neurosurgeon after an examination and a review of the documents, and long-term rehabilitation after surgery is essential.
Selective dorsal rhizotomy (SDR)
the main operation for leg spasticity
Through a small incision in the lower back, the surgeon uses intraoperative equipment to find the nerve fibers that send excessive signals and selectively cuts some of them. Nearby nerves are not damaged.
Intrathecal baclofen pump
another surgical way to reduce muscle tone
A pump placed under the skin delivers baclofen directly to the spinal cord. A pediatric neurosurgeon considers this method alongside rhizotomy.
Botulinum injections
injections into individual muscles
The drug temporarily reduces muscle tone where it is injected. If the effect of the injections wears off quickly, doctors discuss surgical treatment.
Rehabilitation after rhizotomy
an essential stage of treatment
After surgery the muscles become weaker and need to be strengthened gradually. Rehabilitation takes a long time, and the first months are especially intensive.
Assessment before surgery
examination, MRI and videos of movement
The neurosurgeon assesses the form of cerebral palsy, the child's age, muscle strength and motor skills. This determines whether rhizotomy is suitable.
Which treatment methods suit your case?
Our doctor-coordinator will review your medical records and find a specialist to assess your treatment options.
A CLINIC FOR YOUR DIAGNOSIS
Clinics for selective dorsal rhizotomy abroad
Why we suggest these clinics
When selecting clinics, our doctor-coordinators consider the specialists' experience in treating spastic cerebral palsy, the clinic's capabilities and our experience supporting patients there. We recommend a specific doctor and clinic after reviewing your medical records.
Why this clinic is considered for rhizotomy in cerebral palsy
Children's center with a neurosurgery department
A university-affiliated hospital that specializes in treating children and teenagers with complex surgical cases. Its pediatric neurosurgery department is headed by a surgeon who performs selective dorsal rhizotomy for children with cerebral palsy.
About the clinic, certification and services+
Schneider Children’s Medical Center is a university-affiliated multidisciplinary hospital in Israel, recognized as one of the best in the Middle East. Its main areas include hematology, oncology, organ and bone marrow transplantation, endocrinology and cardiology. The hospital is JCI accredited.
Certificates and accreditations
JCI American Medical Institutions Accreditation
environmental management system
Academy of Osseointegration
Canadian Accreditation Center (Diamond Status Level)
Additional services:
Transfer from / to the airport · Visa assistance · Personal assistant · Internet · Reservation of accommodation and airline tickets · Translator · Accommodation for accompanying person · Single room
Cost and terms depend on the medical case and are specified in the treatment plan.
Why this clinic is considered for rhizotomy in cerebral palsy
Neurosurgery centers of Turkey's largest network
The Acibadem network includes specialized neurosurgery centers, and its clinics receive patients from many countries. The coordinator chooses a pediatric neurosurgeon for rhizotomy after reviewing your child's documents.
About the clinic, certification and services+
Acibadem is the largest medical group in Turkey, with 22 university clinics in 5 countries and more than 40 thousand international patients a year. Its clinics are JCI accredited. The coordinator agrees on the clinic in the network and the doctor before your trip.
Certificates and accreditations
ISO 27001 Information Security Management System
Quality Management System Certification for compliance with ISO 9001 in the German accreditation system DAkkS
Joint Commission International
ISO 15189
The World's Best Hospitals 2019
Additional services:
Transfer from / to the airport · Visa assistance · Personal assistant · Internet · Reservation of accommodation and airline tickets · Translator · Accommodation for accompanying person · Single room
Cost and terms depend on the medical case and are specified in the treatment plan.
Why this clinic is considered for rhizotomy in cerebral palsy
Pediatrics and rehabilitation in one center
Sheba treats complex cases in pediatrics and rehabilitation, which matters because long rehabilitation follows rhizotomy. The coordinator will confirm the pediatric neurosurgeon and whether the operation is available for your child before the trip.
About the clinic, certification and services+
Sheba Medical Center is the largest medical facility in the Middle East and treats patients from all over the world. It was the first hospital in Israel to receive JCI accreditation and uses advanced diagnostic and treatment methods based on its own research.
Certificates and accreditations
JCI American Medical Institutions Accreditation
I-CORE (Israeli Centers for Research Excellence) "Center of Scientific Excellence".
Best Smart Hospitals in the World 2021 by Newsweek Magazine
The best clinics in the world 2022 according to Newsweek magazine
Best smart hospitals in the world 2023 according to Newsweek magazine
Additional services:
Transfer from / to the airport · Visa assistance · Personal assistant · Internet · Reservation of accommodation and airline tickets · Translator · Accommodation for accompanying person · Single room
Cost and terms depend on the medical case and are specified in the treatment plan.
The selective dorsal rhizotomy cost depends on the scope of pre-operative tests, additional consultations and the clinic. The clinic gives the exact price after reviewing your child's documents, and we send you programs from several clinics so you can compare prices and what is included. Experts Medical services are free for families, and you pay the clinic directly.
Prices are approximate. The final cost depends on your personalized treatment plan and the services included.
Doctor selection and support are free of charge for you.
No markups. You pay for treatment directly at the clinic.
How the price is formed and what the budget includes
What affects the cost
The treatment method and extent, the chosen clinic, the length of hospital stay and the need for additional tests.
Which medical expenses to check
Tests, doctors’ fees, inpatient stay, medication and follow-up consultations. What is included depends on the program.
Which travel expenses to plan for
Flights, accommodation outside the clinic, transfers, an interpreter and a companion’s stay. The doctor-coordinator will clarify what is included in the offer and what is paid separately.
Rhizotomy in children: what parents should know
Selective dorsal rhizotomy is performed for children with spastic forms of cerebral palsy. The family prepares in advance not only for the trip but also for regular therapy sessions after surgery.
Review before the trip
The neurosurgeon studies the medical reports, MRI and videos of how the child sits, stands and moves.
Observation after surgery
For the first 24 hours after surgery, the child stays in the postoperative ward under constant medical supervision.
Long rehabilitation
Therapy strengthens the muscles and develops balance and new skills, and without it the effect of the operation may be low.
We help pay for children's treatment
We help families apply to charitable foundations for financial support for a child's treatment.
Whether help is available and how much depends on the foundation's terms and decision.
SPECIALIST DOCTORS
Pediatric neurosurgeons for rhizotomy in cerebral palsy
Our medical board selects a doctor experienced in treating your specific diagnosis. We rely on the results of their previous patients, the clinic's capabilities and your budget.
35+years of experience
Pediatric neurosurgery
Memet Ozek
Pediatric neurosurgeon
Professor and President of the European Association of Pediatric Neurosurgery in 2008-2010. Member of ESPN and ISPN, author of scientific publications in pediatric neurology and epilepsy.
Experience and achievements+
Professor, has 13 scientific publications in medical journals in pediatric neurology and epilepsy.
Member of the following organizations:
European Society for Pediatric Neurosurgery (ESPN)
International Society for Pediatric Neurosurgery (ISPN)
Society for Hydrocephalus and Spina Bifida Research
Association of Pediatric Neurology of Turkey
Association of Pediatric Oncology of Turkey
President of the European Association of Pediatric Neurosurgery (2008-2010)
Association of Neurosurgery of Turkey
20+years of experience
Schneider · pediatric neurosurgery
Amir Kershenovich
Neurosurgeon, oncologist
Head of the Department of Pediatric Neurosurgery at Schneider Children’s Medical Center. Performs selective dorsal rhizotomy for children with cerebral palsy and implants intrathecal baclofen pumps.
Experience and achievements+
Doctor of Medical Sciences. Head of the Department of Pediatric Neurosurgery at the Schneider Clinic.
Dr. Kershenovich is a recognized specialist in operations:
Craniotomy
Removal of tumors in the spinal cord in children
Surgical treatment of epilepsy
Surgical treatment of Chiari defect
Surgical treatment of syringomyelia
Endoscopic surgery in the treatment of hydrocephalus and arachnoid cysts
Installation of ventriculo-peritoneal shunts
Surgical treatment of children with cerebral palsy: selective dorsal rhizotomy, intrathecal baclofen pumps, DREZL – dorsal root entry zone lesioning
Surgical treatment of craniosynostosis: metopic, cranial, sagittal, multilayer, with or without Aperts, Crouzon, Pfeifer, Jackson Weis and others syndromes. Including open reconstructive surgeries and minimally invasive multilayer surgeries (also known as “cranial orthosis”)
Cranioplasty
Congenital malformations of the spine, including spina bifida (intrauterine surgery) and release of spinal cord incarceration.
Surgical treatment of encephalocele
Surgical cerebral palsy treatment: we will prepare your records for doctors abroad
We translate your medical documents free of charge and prepare a medical file so that specialists abroad can assess your situation and suggest a treatment plan.
A doctor-coordinator reviews your situation
They will review your medical records, clarify your preferences and help you choose the right specialist.
The doctor you choose reviews your case
The coordinator arranges for your records to be reviewed by a specialist experienced in treating spastic cerebral palsy.
You receive a plan and cost
Before you travel, you can review the clinic's offer, the services included and the planned length of stay.
The doctor-coordinator will tell you where to start and which documents are needed in your case.
Since 2016 we have helped more than 12,000 patientsget quality treatment
Professor Memet Ozek on a breakthrough in cerebral palsy treatment
Memet OzekPediatric neurosurgeon · 35+ years of experiencePediatric neurosurgery
Professor and President of the European Association of Pediatric Neurosurgery in 2008-2010. Member of ESPN and ISPN, author of scientific publications in pediatric neurology and epilepsy.
Surgical cerebral palsy treatment: selective rhizotomy program day by day
The actual schedule, hospital stay and length of the trip are determined by the doctor.
The doctor-coordinator reviews your medical records and clarifies your preferences, budget and travel dates.
02We select a doctor and clinic
We recommend a specialist experienced in similar cases, taking into account the clinic's capabilities and our experience supporting patients there.
03We agree on the plan and cost
We arrange for a specialist doctor to review your case and help you understand the proposed plan, the services included and the cost.
04We organize your trip
We agree on appointment dates and help with tickets, visa, transfers and accommodation.
05We support you during treatment
Your doctor-coordinator stays in touch and helps with practical matters and communication with the clinic.
06We stay with you after you return
We help you get the necessary documents, arrange follow-up consultations and stay in touch with your doctor.
Additional services
Free
Visa assistance
Airport transfers
Personal doctor-coordinator
Accommodation and flight booking
Interpreter
Accommodation for a companion
Private room
How we help after you return home
We help you get the discharge summary and the clinic’s recommendations for further treatment and monitoring.
If needed, we help arrange translation of your medical records.
We arrange follow-up consultations with the clinic’s doctors, including online. We confirm the format and cost of the consultation in advance.
We help you get answers from your doctor to questions about the recommendations you received.
Reviews of rhizotomy for cerebral palsy
Alina Konevskaya and Bogdan
20/04/2021 Diagnosis: Cerebral palsy
★★★★★5/5
Two months after the operation, the set goals were achieved – Bogdan began to walk.
Of course, there is still a lot of work to be done.
A
Alina and Nastia
17/07/2020 Diagnosis: Cerebral palsy
★★★★☆4/5
4 months have passed since my daughter’s operation (belt rhizotomy).
We went to a consultation, where they told us that the result was good, the legs relaxed, the spine is good. She doesn’t need anymore to wear the corset but our Nastena arches very much the head back and it’s still difficult to bend the…
Natalya L.
11/20/2019 Diagnosis: Cerebral palsy
★★★★★5/5
After rhizotomy, difficult work to retrain the muscles and strengthen them is needed.
Changing habits is very difficult. An easy example is as follows: you have always eaten and written with your right hand, and now you need to relearn how to do everything with your left hand without using your right hand. Is it really…
Ilona Vasilyeva
Diagnosis: Cerebral palsy
★★★★☆4/5
My son did not sleep for 6 years, his legs were spinning in his arms.
This is why we decided. Now he can even hold a brush, he loves to draw. Now he feels really better.
Reviews describe personal experiences and do not guarantee the same treatment results.
Examining your child before rhizotomy
Before drawing up a treatment plan, doctors review the tests you have already had and decide whether additional ones are needed. Some records can be assessed before you travel.
01
Which tests may be needed
Pre-operative tests and an MRI are done before surgery. If needed, the child is also seen by a cardiologist, an ophthalmologist, an endocrinologist and other specialists.
If X-rays of the hip joints and spine have been taken, bring them with you. If the spine is curved, doctors will discuss scoliosis treatment separately.
02
When to ask for a review
It is worth sending your documents to a neurosurgeon if your child has spastic cerebral palsy with increased muscle tone in the legs, spasticity makes sitting, standing or walking harder, and the effect of botulinum injections wears off quickly.
A review is also useful when a doctor has suggested rhizotomy and you want a second opinion. It is important that the family is ready for long rehabilitation after surgery.
03
What can be assessed before the trip
Based on the neurologist’s reports, MRI and videos of movement, the neurosurgeon can give a preliminary view on whether rhizotomy is suitable for your child. The final decision is made after an examination at the clinic.
We will help you choose a clinic for your caseOur doctor-coordinator will review your medical records, explain the differences between clinics and help you choose the right specialist.
TREATMENT IN DETAIL
Selective rhizotomy abroad in detail
Selective dorsal rhizotomy for cerebral palsy
Modern progressive surgical technologies make it possible to significantly improve the condition of a patient with cerebral palsy. So, selective dorsal rhizotomy is an operation, after which involuntary movements or muscle spasms disappear. The patient gets rid of pain, socializes better, and care for him is simplified. Another obvious advantage of this operation is that it significantly reduces the number of subsequent orthopedic surgeries.
For whom is the SDR recommended?
The optimal age for selective dorsal rhizotomy is 3-8 years.
The intervention is performed on patients with spastic diplegia, the most common form of cerebral palsy, in which the muscles of the limbs contract involuntarily.
What is the purpose of the operation?
Involuntary convulsions with cerebral palsy are the result of damage to brain activity: the brain transmits incorrect signals through the nerve endings, causing the muscles of the arms or legs to contract involuntarily. If we exclude nerve endings from this chain (brain – nerves – muscles), spasticity either disappears altogether or noticeably decreases. As a result of the operation, the muscles relax, and the child gets rid of the pain.
How is the SDR going?
Selective dorsal rhizotomy is a minimally invasive neurosurgical operation: damage to healthy tissues is minimized. First, the neurosurgeon makes a small incision in the spine to provide access to the spinal canal. Then, with the help of intraoperative equipment, the nerve endings are determined, which are responsible for the increased tone of certain muscles. After that, thin fibers that transmit spastic impulses intersect. Thanks to innovative equipment, manipulations are carried out without damaging the nerve endings nearby.
After suturing the tissues and the surgical wound, the patient is placed for 24 hours in the postoperative ward. Day after day, the patient is constantly monitored and the work of all organs and systems is verified as well.
Do you need rehabilitation?
After the operation, there is a sharp weakening of the muscles. Since they have not worked normally since birth, there is a risk that muscle weakness will develop.
There is a condition, in which even those motor skills that the patient previously had may disappear. Therefore, rehabilitation is an important and mandatory stage, without which the effectiveness of the operation may be low.
What are the chances of success?
The efficiency of selective dorsal rhizotomy is quite high, over 90%. Moreover, the achieved effect persists for many years.
Which method or combination of methods is right for you is decided by a medical board after reviewing your records.
Get a plan and price for rhizotomy for cerebral palsy after a review by a pediatric neurosurgeon
Surgical cerebral palsy treatment: parents' questions about rhizotomy
About choosing a doctor, costs and preparing for treatment.
Can we get a treatment plan and price before the trip?
Yes. Selective rhizotomy is planned after a review of the documents: our coordinating doctor sends your child’s medical reports, MRI and videos of movement to a clinic neurosurgeon. The clinic prepares a preliminary program and cost estimate, and the doctor makes the final decision about surgery after an examination.
Who is selective dorsal rhizotomy suitable for?
The operation is considered for spastic forms of cerebral palsy, most often spastic diplegia, when increased muscle tone in the legs prevents the child from moving and developing. According to clinics, the optimal age is 3-8 years, and muscle strength and motor skills also matter.
Through a small incision in the lower back, the neurosurgeon gains access to the spinal canal, uses intraoperative equipment to find the fibers that carry spastic impulses and cuts them without damaging nearby nerves.
For the first 24 hours after surgery, the child stays in the postoperative ward under constant medical supervision. How long the operation takes depends on the case, and the coordinator will check this with the clinic.
What is the selective dorsal rhizotomy success rate?
The operation reduces excessive muscle tone in the legs, so it may become easier for the child to sit, stand and move and for parents to provide care. According to clinics, the effectiveness of rhizotomy is over 90%, and the effect lasts for many years.
The operation targets the leg muscles and does not solve all movement problems. The result depends on the form of cerebral palsy, age, muscle strength and regular rehabilitation, so only the neurosurgeon can give an outlook for your child.
How long is the trip for rhizotomy?
Under the clinic program, the trip takes about 10 days: tests on day 1, surgery on day 4, discharge on day 6, a follow-up examination on day 7 and return home on day 10. The coordinator will confirm the exact schedule with the clinic.
Is rehabilitation needed after rhizotomy?
Yes, it is an essential stage: after surgery the muscles become weaker and need to be strengthened gradually. Rehabilitation takes a long time, and the first months are especially intensive.
Sessions should not be skipped, because they build strength, balance and new skills. Learn more about programs on the page on rehabilitation for cerebral palsy.
What complications are possible?
Like any operation, rhizotomy can have complications: leg weakness, changes in sensation or bladder function, wound infection, or leakage of cerebrospinal fluid. They are rare, and the neurosurgeon will explain the risks in your child’s case during the consultation.
Can we get help paying for treatment?
Yes. For patients under 18, Experts Medical helps prepare applications to foundations abroad, and the compensation can be up to €20,000. Whether help is possible and how much depends on the foundation’s conditions, so please ask the coordinator.
Which documents are needed, and do they need to be translated?
Prepare a neurologist’s report, a brain MRI, videos of how your child moves and information about previous treatment. Before ordering a translation, check the requirements with the coordinating doctor: they will tell you in what format to send the documents and help with translation if necessary.
More about rhizotomy, cerebral palsy and pediatric neurosurgery
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