Tendon Lengthening Following SDR
For appointments call 314.454.KIDS (5437) or 800.678.KIDS (5437)
|Download our Tendon Lengthening Following SDR Brochure|
Patients who undergo selective dorsal rhizotomy (SDR) surgery at St. Louis Children’s Hospital’s Center for Cerebral Palsy Spasticity often need an additional surgical procedure for muscle/tendon lengthening to relieve contracture (limited motion) in their joints.
Matthew Dobbs, MD, a Washington University orthopedic surgeon at St. Louis Children’s Hospital, uses a minimally-invasive surgical procedure to accomplish the lengthening. This allows the muscle to return to its normal length and the joint to straighten, and is one step in helping children walk with their heels on the floor and knees straight.
Unlike other surgical approaches to tendon lengthening, the minimally-invasive procedure allows for a quicker recovery and requires no leg casts. In most cases, children start therapy the next day.
Muscle/Tendon Lengthening Procedure
The surgery is accomplished using a minimally invasive approach for controlled lengthening. The hamstring, gastroc and heel cord are the most common structures that need lengthening. The procedure is performed in an operating room.
|Dr. Matthew Dobbs discusses the benefits of a minimally-invasive surgical procedure for tendon lengthening.|
In most cases, patients spend one night in the hospital and start physical therapy the day after surgery. No casts are required; your child will be fitted for specially-designed braces to wear post- lengthening to help with standing and walking.
Children who undergo either the selective dorsal rhizotomy surgery alone or in combination with follow-up tendon lengthening may experience rapid and dramatic changes in their walking. To enhance their recovery and improvement, we recommend physical therapy (PT) four to five times a week for the first six months; three to four times per week for the next six months; and two to four times a week for the following year or longer. The intense PT schedule helps children maintain their motion and their maximum strength and walking potential.
A specially-trained pediatric physical therapist will work with your child while they are at the hospital, and create an individualized plan to continue the therapy once they return home.
After heel cord/gastroc lengthening surgery, your child will wear an ankle foot orthosis, or AFO, to assist with walking. As your child gets stronger, he or she may transition to a less restrictive splint such as a SMO or DAFO.
After hamstring lengthening surgery, your child will wear nighttime knee splints to maintain correction.
Eligibility for Surgery
Matthew Dobbs, MD, pediatric orthopedic surgeon, and T.S. Park, MD, pediatric neurosurgeon, will evaluate a patient’s eligibility for the tendon lengthening surgery. If your child is a candidate for tendon lengthening, the procedure is typically performed 2-8 weeks after SDR surgery.
For more information about selective dorsal rhizotomy surgery or minimally invasive tendon lengthening surgery at St. Louis Children’s Hospital, contact us at 314.454.KIDS (5437) or 800.678.KIDS (5437).