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Selective Dorsal Rhizotomy and Intraoperative Neurophysiological Monitoring: Theory to Practice

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Intraoperative Monitoring

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Abstract

Selective dorsal rhizotomy (SDR) is a powerful technique to reduce spasticity, especially in children with cerebral palsy. SDR identifies and sections dorsal roots to reduce spasticity, preserving muscle strength and sphincter functions (Pasquali et al. Childs Nerv Syst 36:1907–1918, 2020).

This chapter introduces the neurophysiological bases of muscle tonus and spasticity, indicates which patients benefit most from SDR, outlines the history and intraoperative neurosurgical and neurophysiological techniques as well as their most frequent difficulties, and suggests how to overcome them.

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Abbreviations

BCR:

Bulbocavernosus reflex

EEG:

Electroencephalography

EMG:

Electromyography

fEMG:

Free EMG

GMFMS:

Gross Motor Function Measure Score

IONM:

Intraoperative neurophysiological monitoring

MEP:

Motor evoked potential

MRI:

Magnetic resonance imaging

SDR:

Selective dorsal rhizotomy

SSEP:

Somatosensory evoked potential

tEMG:

Stimulus-triggered EMG

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Author information

Authors and Affiliations

  1. Brazilian Clinical Neurophysiology Society, Porto Alegre, RS, Brazil

    Carlo Domênico Marrone

  2. Intraoperative Neurophysiological Monitoring, Department Coordinator of Hospital da Criança Santo Antônio, Porto Alegre, RS, Brazil

    Carlo Domênico Marrone

  3. Universidade Federal de Ciências da Saúde de Porto Alegre - UFCSPA, Porto Alegre, RS, Brazil

    Carlo Domênico Marrone

  4. Clínica Marrone, Clinical Neurophysiology, Porto Alegre, RS, Brazil

    Carlo Domênico Marrone

  5. Brazilian Society of Pediatric Surgery, Porto Alegre, RS, Brazil

    André Bedin

  6. Department of Neurophysiology, Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brazil

    Ana Maria Hoppe

  7. Department of Neurophysiology – Santa Casa de Misericórdia de Porto Alegre/RS, Porto Alegre, RS, Brazil

    Cristiane Soveral D’Aviz

  8. Pediatric Neurosurgery Department, Clinical Hospital of the Medical School of the University of Rio Grande do Sul, Porto Alegre, RS, Brazil

    Jorge Wladimir Junqueira Bizzi

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  1. Carlo Domênico Marrone
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  2. André Bedin
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  4. Cristiane Soveral D’Aviz
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  5. Jorge Wladimir Junqueira Bizzi
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Corresponding author

Correspondence to Carlo Domênico Marrone .

Editor information

Editors and Affiliations

  1. Instituto de Ensino e Pesquisa (Research and Teaching Institute), Hospital Sírio Libanês, São Paulo, Brazil

    Silvia Mazzali Verst

  2. Neurophisiology Department, Vitoria Apart Hospital, Serra, Espírito Santo, Brazil

    Maria Rufina Barros

  3. Neurosurgery Department, Hospital Sírio Libanês, São Paulo, São Paulo, Brazil

    Marcos Vinicius Calfat Maldaun

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Marrone, C.D., Bedin, A., Hoppe, A.M., D’Aviz, C.S., Bizzi, J.W.J. (2022). Selective Dorsal Rhizotomy and Intraoperative Neurophysiological Monitoring: Theory to Practice. In: Verst, S.M., Barros, M.R., Maldaun, M.V.C. (eds) Intraoperative Monitoring. Springer, Cham. https://doi.org/10.1007/978-3-030-95730-8_26

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  • DOI: https://doi.org/10.1007/978-3-030-95730-8_26

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-95729-2

  • Online ISBN: 978-3-030-95730-8

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