Outcomes of selective dorsal rhizotomy in ambulatory children and young people with cerebral palsy: A scoping review

TL;DR

This scoping review examines the outcomes of selective dorsal rhizotomy in children with cerebral palsy, focusing on how research has shifted from impairment-based to more holistic measures over time.

Contribution

The study provides a comprehensive overview of outcome reporting trends in SDR research using the ICF framework.

Findings

Most studies focused on body function and structure outcomes, with fewer on participation and quality of life.

Recent years show a small shift toward participant-reported outcomes and quality-of-life measures.

Few studies considered personal and environmental factors in SDR outcomes.

Abstract

To identify outcomes reported after selective dorsal rhizotomy (SDR) in ambulant children and young people with cerebral palsy in different domains of the International Classification of Functioning, Disability and Health (ICF).

A scoping review using the JBI Scoping Review methodology was conducted. Six databases were searched for literature published between 1993 and 2024.

A total of 214 published papers met the inclusion criteria. Outcomes under the body function and structure domain were most frequently investigated (n = 199, 93%), followed by activity (n = 123, 58%) and participation (n = 33, 15%) across all studies. Quality of life was reported in 16 (8%) studies, and four (2%) studies mentioned individualized goals for SDR surgery. A combination of validated measures and subjective outcomes was used, with 119 (56%) studies reporting outcomes in two or more domains.

Impairment‐based outcomes remain the primary focus in SDR research. A small shift in emphasis towards participant‐reported outcome measures has been seen in recent years. Few studies reported on the impact of personal and environmental factors. Future SDR studies need to incorporate all domains of the ICF to enhance understanding and capture holistic, meaningful changes in the lives of children and young people with cerebral palsy and their families.

This scoping review highlights that in the selective dorsal rhizotomy (SDR) literature, the emphasis still remains on impairment‐based outcomes in the body function and structure domain of the ICF. However, there has been a small shift towards participation and quality‐of‐life outcomes in the last decade. While many studies focus on the quantitative outcome data of SDR, little research has explored children and young people's and parental perspectives around SDR.

Plain language summary: https://onlinelibrary.wiley.com/doi/10.1111/dmcn.70048

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