Frequently Asked Questions about the referral process

Selective Dorsal Rhizotomy - SDR
NHS GGC

How can I refer one of my patients into this service?

Each local area will have a multidisciplinary team managing complex motor disorders and children with spasticity. These multidisciplinary (MDT) teams should discuss children potentially suitable for SDR and assess if they fit the referral criteria. If the local MDT agrees, the child should be referred via the electronic referral form.

Realistic outcomes and the limitations of all therapies should be discussed with the family as SDR. Families also need to be aware of and agree to an increased programme of home exercises following the procedure.

What information do I need to provide/assessments will I need?

  • Full CPIPS assessment (pre-op and annually post-op)
  • GMFM-66 (no more than 6 months prior to procedure) ** contact us for help if required.

Other referral Information required from local MDT

The child should have had:

  • Recent gait analysis (< 6 months prior to referral).
  • Recent hip x-ray (Reimers<40% bilaterally).
  • MRI brain and MRI spine.

Other referral information required from local Multi-disciplinary team

  • Approval by the Physiotherapy Manager of the child’s Health Board that appropriate community physiotherapy resource is available.
  • If SDR is considered by the National MDT team to be the optimal tone management strategy then approval from the Physiotherapy Manager for the child’s Health Board will be sought to confirm that appropriate community physiotherapy resources are available.
  • This will precede arranging an out-patient visit pre-operatively with the neuro-surgical team.

Other referral information required from local Multi-disciplinary team

  • Approval by the Physiotherapy Manager of the child’s Health Board that appropriate community physiotherapy resource is available.
  • If SDR is considered by the National MDT team to be the optimal tone management strategy then approval from the Physiotherapy Manager for the 
    child’s Health Board will be sought to confirm that appropriate community physiotherapy resources are available.
  • This will precede arranging an out-patient visit pre-operatively with the neuro-surgical team.

Where will the patient go for their surgery?

The inpatient SDR surgery and immediate post-operative inpatient rehabilitation will take place in The Royal Hospital for Children, Glasgow.

How long will the child have physiotherapy in the hospital?

At present the children will be seen by the acute hospital based physiotherapy service for up to 3 weeks postoperatively, then a detailed handover will be given to transfer care back to the child’s local community physiotherapist.

If convenient, the local physiotherapist will be invited to come into the hospital to have a joint session prior to hospital discharge.