Patients who undergo selective dorsal rhizotomy surgery at St. Louis Children’s Hospital’s Center for Cerebral Palsy Spasticity often need an additional surgical procedure for tendon lengthening to relieve contracture (limited motion) in their joints. Matthew Dobbs, MD, a Children’s Hospital orthopedic surgeon, uses a minimally invasive procedure to lengthen the tendon. This allows the muscle to return to its normal length and enables the joint to straighten. The most common tendons that need lengthening are the hamstring and/or heel cords.

The lengthening is done in the operating room through small incisions where a controlled lengthening is performed. No casting is required, and patients may spend one night in the hospital. Most patients begin physical therapy the day after surgery. Post-operative bracing is used for standing and advancing with walking. The size of the brace decreases as patients get stronger.

Children who undergo either the selective dorsal rhizotomy surgery alone or in combination with follow-up tendon lengthening change rapidly after surgery. To aid their recovery and advancement, physical therapy (PT) is recommended 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 subsequent year or longer. The intense PT schedule increases the possibility of children reaching their maximum potential. The children’s primary therapists provide the therapy, and they are given the post-op PT protocol best suited to help each individual patient.

Patients’ eligibility for the tendon lengthening surgery is determined through evaluations by both Dr. Dobbs and T.S. Park, MD, neurosurgeon-in-chief at Children’s Hospital and director of the Center for Cerebral Palsy Spasticity.

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).