At Pain Management Manhattan, pain is first treated with the least disruptive techniques. Once a firm diagnosis is reached, rest and ice may be the first line of defense, followed by behavior modifications and corticosteroid injections. But your top-rated Manhattan pain specialists don’t stop until they find a treatment that provides you with long-lasting relief. If all other options haven’t delivered the pain relief you need, your doctor may suggest a selective dorsal rhizotomy (SDR) to get that relief. The best doctors in New York City can perform the right pain-relieving procedure for you.

Dorsal rhizotomy, often referred to as selective dorsal rhizotomy or SDR, is a surgical procedure designed to help if you or a loved one suffers from cerebral palsy or other conditions that involve muscle spasticity. It’s one of the most scrutinized procedures performed, and evidence shows that it’s an excellent option for certain people with spastic conditions that often result in extensive pain.

There are two kinds of nerve roots that lie in the spine and travel outward to your muscles. One is called the ventral spinal root, which works by sending information from your brain to your muscles. The other is called the dorsal spinal root, which brings sensations back from your muscle to the spine and brain. When performing an SDR, your top NYC pain management specialist selects sections to tie or cut off some of the sensory nerve fibers as they travel from the muscles into the spine.

Benefits of Dorsal Rhizotomy

Although often associated with the spasticity issues of individuals dealing with cerebral palsy, SDR also benefits anyone dealing with involuntary muscle contractions. Dorsal rhizotomy surgery, which is a minimally invasive surgical procedure, treats a number of conditions. The surgery helps:

    Selective Dorsal Rhizotomy in NYC
    Selective Dorsal Rhizotomy in NYC

  • Those with cerebral palsy, especially children, dealing with lower extremity spasticity that hinders walking or proper hygiene
  • Individuals who are relatively young, but experiencing the severe contractions associated with Parkinson’s disease
  • Anyone suffering many of the debilitating aspects of multiple sclerosis
  • Any spasticity concerns that haven’t responded to more conventional treatments such as medications or injections
  • People dealing with chronic back pain and in need of a lumbar rhizotomy or cervical rhizotomy to target specific nerves, depending on the source of the pain
  • Those with specific chronic spinal joint pain who can benefit from a facet rhizotomy

The goal of the surgery is to help you regain the ability to walk or to relieve pain by targeting and transecting the nerves that are hindering desired movement. It’s an effective procedure when performed by a trained pain specialist in New York City.

The SDR Procedure

No matter which rhizotomy surgery your best-in-class doctor at NYC center for pain management recommends, you require an inpatient hospital stay of at least a few days. Your doctor instructs you as to the exact process, but you can expect the following general steps:

  • Before you check into the hospital, prepare for general anesthesia by not eating for several hours.
  • You’re given the appropriate medication to make you sleep during the procedure.
  • The surgical team moves onto your stomach so your surgeon can properly access your neck or lower back, depending on where your procedure is to take place.
  • Your surgeon makes a small incision to find the correct nerve bundle or roots that are associated with your pain condition — such as the sensory nerve near your facet joint for lower back pain — and teases apart the separate nerves in any grouping.
  • Your doctor identifies any nerves that seem to be malfunctioning by using a special microscope.
  • Using an electrical probe, your doctor then identifies the exact nerve or nerves that are contributing to your spasticity or affecting the exact location of your pain.
  • Then your doctor disables the nerve with an electric probe to prevent pain signals from reaching your brain.
  • The incision is closed, cleaned and inspected.
  • You’re taken to Recovery, where you’re monitored closely until you’re fully awake and conscious.
  • Depending on where your incision is located, you may have to lie flat for a few days to allow the incision time to heal.
  • Once you’ve healed enough to move around, you start physical therapy, which you continue for several weeks, two to three times a week. You are retraining your other nerves to take over any lost function.

Selective Dorsal Rhizotomy Recovery

Without physical therapy, your other nerves won’t be able to take over the duties required for walking and other activities. You have to follow the physical therapy exercises to fully retrain your brain, muscles and nerves to recover desired mobility. Because you’re being treated by a team of top-notch doctors and staff, you know what to expect during each step of your recovery progress.

Because it’s a more invasive procedure than many other options, your doctor usually doesn’t recommend a selective dorsal rhizotomy as a first treatment option. But if you haven’t found results from more conservative treatments, you may find relief with SDR or other rhizotomy procedures. You can trust your exceptionally well-trained pain management specialist in NYC. Contact the practice today whenever you feel severe back or pelvic pain.

Page Modified on Dec 30, 2021 by Dr. Leon Reyfman, MD (Pain Management Doctor)
Leon Reyfman, MD | Interventional Pain Management Doctor in New York City

Leon Reyfman, MD, is a top-rated, best-in-class interventional pain management doctor. He is a nationally recognized pain relief specialist and is among the top pain care doctors in New York City and the country. He is an award-winning expert and contributor to prominent media outlets.

Dr. Leon Reyfman has been recognized for his thoughtful, thorough, modern approach to treating chronic pain. He has been named a "top pain management doctor in New York" and one of "America's Top Doctors™" for advanced sports injury treatments. Among other accolades, he was voted by peers as a "Castle Connolly Top Doctors™" and "New York Super Doctors™". Dr. Leon Reyfman was a part of the medical team at the 2016 Summer Olympic Games in Rio de Janeiro, Brazil.

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